| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| V2020 |
Frames, purchases |
6,269 |
6,177 |
$453K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
2,571 |
2,512 |
$189K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
3,329 |
3,293 |
$106K |
| V2203 |
Spherocylinder, bifocal, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
1,058 |
1,027 |
$102K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
1,398 |
1,379 |
$101K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
1,865 |
1,851 |
$85K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
1,875 |
1,849 |
$73K |
| 92015 |
Determination of refractive state |
4,201 |
4,026 |
$65K |
| 92341 |
|
1,408 |
1,376 |
$51K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
1,578 |
1,577 |
$50K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
112 |
104 |
$7K |
| V2104 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, 2.12 to 4.00d cylinder, per lens |
194 |
193 |
$4K |
| 92250 |
|
65 |
64 |
$2K |
| V2750 |
Anti-reflective coating, per lens |
30 |
30 |
$1K |
| V2200 |
Sphere, bifocal, plano to plus or minus 4.00d, per lens |
13 |
13 |
$750.75 |