| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
3,319 |
3,171 |
$193K |
| V2020 |
Frames, purchases |
1,470 |
1,412 |
$106K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
1,399 |
1,356 |
$62K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
3,877 |
3,850 |
$55K |
| V2025 |
Deluxe frame |
3,508 |
3,486 |
$40K |
| 92015 |
Determination of refractive state |
5,084 |
4,884 |
$40K |
| 92250 |
|
123 |
107 |
$3K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
2,233 |
2,185 |
$1K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
14 |
14 |
$930.54 |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
2,965 |
2,929 |
$585.00 |
| V2750 |
Anti-reflective coating, per lens |
57 |
56 |
$2.50 |
| V2203 |
Spherocylinder, bifocal, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
143 |
139 |
$0.00 |
| V2107 |
Spherocylinder, single vision, plus or minus 4.25 to plus or minus 7.00 sphere, .12 to 2.00d cylinder, per lens |
35 |
33 |
$0.00 |
| V2104 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, 2.12 to 4.00d cylinder, per lens |
565 |
559 |
$0.00 |
| V2200 |
Sphere, bifocal, plano to plus or minus 4.00d, per lens |
21 |
21 |
$0.00 |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
389 |
346 |
$0.00 |
| V2105 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, 4.25 to 6.00d cylinder, per lens |
27 |
27 |
$0.00 |
| V2744 |
Tint, photochromatic, per lens |
132 |
124 |
$0.00 |
| V2101 |
Sphere, single vision, plus or minus 4.12 to plus or minus 7.00d, per lens |
31 |
15 |
$0.00 |