| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
1,831 |
877 |
$56K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
872 |
863 |
$37K |
| V2783 |
Lens, index greater than or equal to 1.66 plastic or greater than or equal to 1.80 glass, excludes polycarbonate, per lens |
708 |
286 |
$32K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
1,293 |
640 |
$23K |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
385 |
368 |
$13K |
| V2020 |
Frames, purchases |
1,339 |
1,198 |
$10K |
| 92015 |
Determination of refractive state |
1,569 |
1,535 |
$9K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
250 |
119 |
$4K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
40 |
40 |
$2K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
13 |
12 |
$388.50 |
| 92002 |
|
12 |
12 |
$340.08 |