| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| V2020 |
Frames, purchases |
15,710 |
15,008 |
$353K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
8,772 |
8,720 |
$350K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
11,526 |
11,449 |
$251K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
6,350 |
6,306 |
$213K |
| 92015 |
Determination of refractive state |
15,958 |
15,847 |
$128K |
| 92250 |
|
1,771 |
1,753 |
$61K |
| 92341 |
|
1,829 |
1,820 |
$54K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
1,208 |
1,143 |
$26K |
| V2750 |
Anti-reflective coating, per lens |
232 |
206 |
$17K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
498 |
224 |
$12K |
| 92225 |
|
106 |
53 |
$5K |
| V2203 |
Spherocylinder, bifocal, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
64 |
31 |
$3K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
241 |
137 |
$2K |
| V2781 |
Progressive lens, per lens |
38 |
14 |
$2K |
| 92226 |
|
23 |
12 |
$907.58 |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
16 |
16 |
$906.08 |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
41 |
24 |
$336.61 |
| 92133 |
|
12 |
12 |
$275.57 |
| 99072 |
|
77 |
64 |
$0.00 |