| Code | Description | Claims | Bene. Records | Total Paid |
|---|
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
5,150 |
4,841 |
$623K |
| V2020 |
Frames, purchases |
7,342 |
6,715 |
$355K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
3,204 |
3,012 |
$318K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
3,482 |
3,190 |
$182K |
| 92015 |
Determination of refractive state |
8,901 |
8,360 |
$143K |
| V2410 |
Variable asphericity lens, single vision, full field, glass or plastic, per lens |
587 |
525 |
$96K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
1,506 |
1,397 |
$73K |
| V2755 |
U-v lens, per lens |
1,203 |
1,088 |
$31K |
| V2203 |
Spherocylinder, bifocal, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
107 |
98 |
$8K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
104 |
85 |
$7K |
| V2104 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, 2.12 to 4.00d cylinder, per lens |
153 |
130 |
$6K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
121 |
97 |
$5K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
18 |
14 |
$1K |
| 92310 |
|
33 |
28 |
$120.00 |