| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
4,028 |
1,911 |
$81K |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
1,384 |
1,384 |
$55K |
| V2020 |
Frames, purchases |
3,004 |
2,877 |
$34K |
| 92002 |
|
667 |
667 |
$26K |
| V2200 |
Sphere, bifocal, plano to plus or minus 4.00d, per lens |
527 |
262 |
$14K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
296 |
148 |
$6K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
134 |
134 |
$5K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
122 |
117 |
$4K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
87 |
87 |
$3K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
6,192 |
2,967 |
$0.00 |