| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
17,051 |
11,869 |
$1.06M |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
10,296 |
10,055 |
$415K |
| V2020 |
Frames, purchases |
14,691 |
13,230 |
$328K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
3,874 |
3,817 |
$159K |
| V2200 |
Sphere, bifocal, plano to plus or minus 4.00d, per lens |
1,538 |
1,266 |
$100K |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
1,854 |
1,852 |
$74K |
| V2500 |
Contact lens, pmma, spherical, per lens |
231 |
231 |
$22K |
| V2750 |
Anti-reflective coating, per lens |
2,377 |
1,739 |
$20K |
| V2744 |
Tint, photochromatic, per lens |
1,195 |
887 |
$18K |
| V2025 |
Deluxe frame |
1,132 |
1,102 |
$13K |
| V2299 |
Specialty bifocal (by report) |
231 |
170 |
$13K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
5,995 |
2,307 |
$10K |
| 92015 |
Determination of refractive state |
816 |
811 |
$8K |
| V2599 |
Contact lens, other type |
65 |
65 |
$7K |
| V2781 |
Progressive lens, per lens |
426 |
320 |
$6K |
| S0621 |
Routine ophthalmological examination including refraction; established patient |
160 |
160 |
$5K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
318 |
265 |
$3K |
| S0620 |
Routine ophthalmological examination including refraction; new patient |
80 |
80 |
$2K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
50 |
49 |
$1K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
28 |
27 |
$954.00 |
| V2760 |
Scratch resistant coating, per lens |
49 |
28 |
$265.00 |
| V2799 |
Vision item or service, miscellaneous |
26 |
26 |
$205.00 |