| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
8,213 |
8,006 |
$552K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
4,009 |
3,938 |
$371K |
| V2020 |
Frames, purchases |
10,873 |
10,255 |
$253K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
5,573 |
5,168 |
$131K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
2,196 |
2,181 |
$58K |
| 92250 |
|
1,065 |
976 |
$50K |
| V2203 |
Spherocylinder, bifocal, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
1,094 |
1,014 |
$36K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
2,098 |
1,826 |
$20K |
| V2200 |
Sphere, bifocal, plano to plus or minus 4.00d, per lens |
288 |
278 |
$10K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
202 |
181 |
$8K |
| V2756 |
Eye glass case |
7,062 |
6,604 |
$7K |
| V2107 |
Spherocylinder, single vision, plus or minus 4.25 to plus or minus 7.00 sphere, .12 to 2.00d cylinder, per lens |
53 |
53 |
$1K |
| V2299 |
Specialty bifocal (by report) |
15 |
15 |
$1K |
| V2781 |
Progressive lens, per lens |
16 |
16 |
$868.84 |
| 92015 |
Determination of refractive state |
486 |
482 |
$90.30 |
| V2025 |
Deluxe frame |
22 |
14 |
$83.26 |
| V2750 |
Anti-reflective coating, per lens |
14 |
13 |
$0.00 |