| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| V2020 |
Frames, purchases |
3,080 |
3,013 |
$111K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
1,343 |
1,333 |
$95K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
2,413 |
1,452 |
$59K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
488 |
486 |
$58K |
| 92015 |
Determination of refractive state |
1,137 |
1,134 |
$19K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
90 |
89 |
$7K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
2,089 |
1,020 |
$540.00 |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
24 |
12 |
$451.88 |