| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
5,985 |
2,802 |
$180K |
| V2783 |
Lens, index greater than or equal to 1.66 plastic or greater than or equal to 1.80 glass, excludes polycarbonate, per lens |
2,684 |
1,118 |
$120K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
2,063 |
2,011 |
$93K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
1,556 |
1,536 |
$91K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
4,451 |
2,231 |
$79K |
| V2020 |
Frames, purchases |
4,118 |
3,693 |
$29K |
| 92015 |
Determination of refractive state |
4,316 |
4,225 |
$26K |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
560 |
548 |
$20K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
1,132 |
612 |
$17K |
| V2203 |
Spherocylinder, bifocal, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
408 |
213 |
$8K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
177 |
165 |
$7K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
206 |
186 |
$6K |
| V2104 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, 2.12 to 4.00d cylinder, per lens |
337 |
185 |
$6K |
| 92002 |
|
154 |
152 |
$5K |
| 92310 |
|
92 |
90 |
$5K |
| V2025 |
Deluxe frame |
255 |
233 |
$3K |