| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| V2020 |
Frames, purchases |
5,251 |
5,079 |
$148K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
2,875 |
2,783 |
$84K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
1,561 |
1,513 |
$67K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
1,415 |
1,380 |
$60K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
2,184 |
2,120 |
$38K |
| 92015 |
Determination of refractive state |
868 |
832 |
$16K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
931 |
892 |
$14K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
178 |
172 |
$12K |
| 92060 |
|
176 |
173 |
$10K |
| V2200 |
Sphere, bifocal, plano to plus or minus 4.00d, per lens |
159 |
152 |
$8K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
1,484 |
1,436 |
$6K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
44 |
44 |
$4K |
| V2107 |
Spherocylinder, single vision, plus or minus 4.25 to plus or minus 7.00 sphere, .12 to 2.00d cylinder, per lens |
188 |
186 |
$3K |
| V2025 |
Deluxe frame |
59 |
58 |
$3K |
| V2101 |
Sphere, single vision, plus or minus 4.12 to plus or minus 7.00d, per lens |
29 |
29 |
$440.00 |
| V2104 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, 2.12 to 4.00d cylinder, per lens |
12 |
12 |
$155.00 |