| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
1,854 |
1,837 |
$83K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
1,489 |
1,477 |
$66K |
| V2020 |
Frames, purchases |
3,001 |
2,963 |
$52K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
2,894 |
2,859 |
$49K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
1,421 |
1,402 |
$31K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
1,305 |
1,293 |
$17K |
| V2200 |
Sphere, bifocal, plano to plus or minus 4.00d, per lens |
106 |
105 |
$5K |
| 92015 |
Determination of refractive state |
250 |
238 |
$5K |
| V2203 |
Spherocylinder, bifocal, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
94 |
93 |
$2K |
| V2025 |
Deluxe frame |
488 |
485 |
$2K |
| V2104 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, 2.12 to 4.00d cylinder, per lens |
157 |
153 |
$2K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
1,273 |
1,250 |
$1K |
| V2101 |
Sphere, single vision, plus or minus 4.12 to plus or minus 7.00d, per lens |
55 |
53 |
$800.00 |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
14 |
14 |
$742.38 |
| V2107 |
Spherocylinder, single vision, plus or minus 4.25 to plus or minus 7.00 sphere, .12 to 2.00d cylinder, per lens |
14 |
14 |
$150.00 |
| V2750 |
Anti-reflective coating, per lens |
115 |
115 |
$0.00 |