| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92065 |
|
12,312 |
2,867 |
$699K |
| 92060 |
|
6,181 |
4,004 |
$331K |
| V2410 |
Variable asphericity lens, single vision, full field, glass or plastic, per lens |
1,861 |
1,240 |
$313K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
4,623 |
3,392 |
$290K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
2,193 |
2,057 |
$215K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
1,182 |
1,153 |
$111K |
| V2020 |
Frames, purchases |
1,969 |
1,380 |
$90K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
2,447 |
1,680 |
$84K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
1,171 |
752 |
$65K |
| V2750 |
Anti-reflective coating, per lens |
1,794 |
1,171 |
$49K |
| V2755 |
U-v lens, per lens |
1,426 |
918 |
$45K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
188 |
174 |
$21K |
| 92066 |
|
632 |
172 |
$14K |
| 92083 |
|
206 |
144 |
$10K |
| V2025 |
Deluxe frame |
94 |
69 |
$9K |
| 96111 |
|
110 |
91 |
$8K |
| 92250 |
|
126 |
116 |
$5K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
14 |
13 |
$2K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
35 |
24 |
$1K |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
15 |
12 |
$806.28 |
| 92015 |
Determination of refractive state |
59 |
59 |
$46.59 |