| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| V2410 |
Variable asphericity lens, single vision, full field, glass or plastic, per lens |
7,831 |
6,474 |
$1.08M |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
10,500 |
9,933 |
$1.05M |
| V2020 |
Frames, purchases |
14,119 |
11,482 |
$561K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
4,306 |
4,048 |
$508K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
8,654 |
7,257 |
$371K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
12,728 |
10,562 |
$328K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
13,884 |
11,309 |
$248K |
| V2104 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, 2.12 to 4.00d cylinder, per lens |
2,542 |
2,120 |
$119K |
| V2750 |
Anti-reflective coating, per lens |
4,231 |
3,212 |
$119K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
1,605 |
1,392 |
$53K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
324 |
291 |
$12K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
173 |
156 |
$11K |
| 92015 |
Determination of refractive state |
15,147 |
14,311 |
$10K |
| V2107 |
Spherocylinder, single vision, plus or minus 4.25 to plus or minus 7.00 sphere, .12 to 2.00d cylinder, per lens |
120 |
90 |
$5K |
| V2105 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, 4.25 to 6.00d cylinder, per lens |
20 |
12 |
$1K |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
52 |
51 |
$901.92 |
| V2199 |
Not otherwise classified, single vision lens |
18 |
16 |
$0.00 |