| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| V2410 |
Variable asphericity lens, single vision, full field, glass or plastic, per lens |
15,196 |
10,735 |
$2.51M |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
6,701 |
6,377 |
$786K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
7,175 |
6,947 |
$752K |
| V2020 |
Frames, purchases |
15,965 |
11,191 |
$711K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
15,492 |
10,939 |
$576K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
10,467 |
7,461 |
$481K |
| V2750 |
Anti-reflective coating, per lens |
15,135 |
10,607 |
$410K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
15,906 |
11,155 |
$317K |
| V2104 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, 2.12 to 4.00d cylinder, per lens |
4,146 |
2,898 |
$201K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
2,674 |
1,968 |
$112K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
824 |
782 |
$34K |
| V2744 |
Tint, photochromatic, per lens |
1,136 |
711 |
$28K |
| V2105 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, 4.25 to 6.00d cylinder, per lens |
312 |
188 |
$17K |
| 92015 |
Determination of refractive state |
13,991 |
13,353 |
$8K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
45 |
34 |
$2K |
| V2107 |
Spherocylinder, single vision, plus or minus 4.25 to plus or minus 7.00 sphere, .12 to 2.00d cylinder, per lens |
24 |
14 |
$2K |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
12 |
12 |
$217.14 |