| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| V2020 |
Frames, purchases |
1,281 |
1,176 |
$42K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
703 |
663 |
$41K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
736 |
372 |
$26K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
196 |
192 |
$19K |
| V2200 |
Sphere, bifocal, plano to plus or minus 4.00d, per lens |
400 |
164 |
$7K |
| 92015 |
Determination of refractive state |
1,446 |
1,391 |
$7K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
257 |
139 |
$7K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
130 |
64 |
$3K |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
72 |
67 |
$2K |
| 92134 |
|
102 |
95 |
$1K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
27 |
26 |
$988.56 |
| 92250 |
|
73 |
68 |
$964.94 |
| 92083 |
|
30 |
28 |
$752.19 |
| 92133 |
|
16 |
14 |
$114.85 |