| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| V2020 |
Frames, purchases |
5,595 |
5,586 |
$174K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
851 |
850 |
$94K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
4,170 |
4,170 |
$78K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
664 |
654 |
$51K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
2,581 |
2,576 |
$46K |
| 92015 |
Determination of refractive state |
2,415 |
2,343 |
$38K |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
454 |
448 |
$23K |
| V2781 |
Progressive lens, per lens |
2,633 |
2,630 |
$11K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
66 |
66 |
$4K |
| V2200 |
Sphere, bifocal, plano to plus or minus 4.00d, per lens |
122 |
122 |
$3K |
| 92341 |
|
21 |
21 |
$881.58 |