| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
4,826 |
2,836 |
$86K |
| V2020 |
Frames, purchases |
3,988 |
3,955 |
$52K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
1,107 |
1,095 |
$48K |
| 92250 |
|
1,102 |
1,096 |
$48K |
| 92002 |
|
1,441 |
1,435 |
$43K |
| 92083 |
|
628 |
625 |
$29K |
| 76512 |
|
410 |
338 |
$24K |
| V2200 |
Sphere, bifocal, plano to plus or minus 4.00d, per lens |
368 |
220 |
$10K |
| 92285 |
|
405 |
405 |
$7K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
469 |
246 |
$5K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
28 |
28 |
$619.86 |
| S0620 |
Routine ophthalmological examination including refraction; new patient |
27 |
27 |
$390.00 |
| 92202 |
|
28 |
28 |
$373.67 |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
282 |
159 |
$298.00 |
| 92015 |
Determination of refractive state |
439 |
436 |
$0.00 |