| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| V2020 |
Frames, purchases |
4,971 |
4,944 |
$344K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
3,905 |
3,888 |
$258K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
2,149 |
2,134 |
$114K |
| 92015 |
Determination of refractive state |
5,108 |
5,084 |
$88K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
1,149 |
1,143 |
$87K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
1,154 |
1,149 |
$57K |
| V2104 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, 2.12 to 4.00d cylinder, per lens |
986 |
977 |
$45K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
254 |
217 |
$12K |
| V2105 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, 4.25 to 6.00d cylinder, per lens |
67 |
67 |
$3K |
| V2108 |
Spherocylinder, single vision, plus or minus 4.25d to plus or minus 7.00d sphere, 2.12 to 4.00d cylinder, per lens |
24 |
24 |
$1K |
| V2109 |
Spherocylinder, single vision, plus or minus 4.25 to plus or minus 7.00d sphere, 4.25 to 6.00d cylinder, per lens |
13 |
13 |
$671.20 |