| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
1,975 |
948 |
$61K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
1,020 |
999 |
$43K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
933 |
492 |
$17K |
| V2783 |
Lens, index greater than or equal to 1.66 plastic or greater than or equal to 1.80 glass, excludes polycarbonate, per lens |
359 |
138 |
$16K |
| V2020 |
Frames, purchases |
1,183 |
1,074 |
$8K |
| 92015 |
Determination of refractive state |
1,313 |
1,287 |
$8K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
399 |
193 |
$6K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
174 |
169 |
$5K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
12 |
12 |
$705.24 |