| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| V2020 |
Frames, purchases |
1,096 |
1,089 |
$68K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
948 |
937 |
$49K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
986 |
983 |
$44K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
352 |
342 |
$11K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
77 |
77 |
$4K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
383 |
383 |
$3K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
27 |
27 |
$2K |
| V2025 |
Deluxe frame |
25 |
25 |
$1K |
| 92015 |
Determination of refractive state |
829 |
819 |
$918.36 |