| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| V2410 |
Variable asphericity lens, single vision, full field, glass or plastic, per lens |
2,690 |
1,848 |
$258K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
2,168 |
2,076 |
$251K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
2,121 |
2,042 |
$204K |
| V2020 |
Frames, purchases |
2,744 |
1,932 |
$97K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
1,398 |
965 |
$63K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
2,974 |
2,076 |
$49K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
3,000 |
2,093 |
$40K |
| V2755 |
U-v lens, per lens |
1,005 |
661 |
$15K |
| V2750 |
Anti-reflective coating, per lens |
1,032 |
674 |
$12K |
| 92250 |
|
180 |
171 |
$9K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
117 |
108 |
$7K |
| 92015 |
Determination of refractive state |
4,589 |
4,398 |
$3K |
| V2104 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, 2.12 to 4.00d cylinder, per lens |
47 |
31 |
$3K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
17 |
13 |
$698.10 |
| 92285 |
|
37 |
37 |
$417.80 |