| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| V2020 |
Frames, purchases |
1,667 |
1,628 |
$55K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
1,119 |
1,098 |
$35K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
631 |
621 |
$28K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
497 |
487 |
$21K |
| 92015 |
Determination of refractive state |
413 |
402 |
$8K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
400 |
394 |
$8K |
| 92060 |
|
39 |
38 |
$2K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
328 |
321 |
$2K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
59 |
58 |
$1K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
12 |
12 |
$813.84 |