| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| V2020 |
Frames, purchases |
2,161 |
1,768 |
$27K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
1,288 |
1,096 |
$24K |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
2,107 |
1,930 |
$24K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
194 |
185 |
$16K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
191 |
163 |
$10K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
125 |
110 |
$8K |
| V2203 |
Spherocylinder, bifocal, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
84 |
51 |
$2K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
44 |
39 |
$528.00 |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
12 |
12 |
$415.30 |
| 92134 |
|
16 |
12 |
$22.65 |
| 92015 |
Determination of refractive state |
661 |
603 |
$0.00 |