| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
18,207 |
5,588 |
$493K |
| V2020 |
Frames, purchases |
9,607 |
6,034 |
$285K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
5,616 |
5,559 |
$236K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
3,496 |
3,460 |
$153K |
| 92250 |
|
1,977 |
1,972 |
$104K |
| V2750 |
Anti-reflective coating, per lens |
1,105 |
459 |
$20K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
1,436 |
1,431 |
$14K |
| 92015 |
Determination of refractive state |
4,476 |
4,420 |
$11K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
131 |
131 |
$9K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
15,211 |
4,513 |
$8K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
84 |
84 |
$4K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
106 |
100 |
$4K |
| 92134 |
|
33 |
33 |
$1K |
| V2200 |
Sphere, bifocal, plano to plus or minus 4.00d, per lens |
30 |
14 |
$1K |
| 92132 |
|
25 |
25 |
$738.90 |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
12 |
12 |
$645.75 |
| 92310 |
|
12 |
12 |
$620.00 |
| 76514 |
|
43 |
43 |
$404.99 |
| 2025F |
|
12 |
12 |
$0.00 |
| 2023F |
|
110 |
107 |
$0.00 |