| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
8,151 |
4,002 |
$171K |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
2,298 |
2,156 |
$64K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
4,158 |
2,038 |
$62K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
2,882 |
1,505 |
$51K |
| V2020 |
Frames, purchases |
4,321 |
3,790 |
$30K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
659 |
646 |
$23K |
| 92015 |
Determination of refractive state |
3,416 |
3,356 |
$20K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
285 |
280 |
$16K |
| V2203 |
Spherocylinder, bifocal, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
392 |
199 |
$7K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
146 |
145 |
$6K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
127 |
124 |
$4K |
| 92002 |
|
101 |
97 |
$3K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
28 |
28 |
$2K |
| V2104 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, 2.12 to 4.00d cylinder, per lens |
102 |
61 |
$2K |
| 92083 |
|
25 |
24 |
$1K |