| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
8,429 |
3,572 |
$231K |
| V2020 |
Frames, purchases |
4,595 |
3,901 |
$185K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
3,158 |
2,988 |
$138K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
3,036 |
2,832 |
$137K |
| 92250 |
|
1,137 |
1,097 |
$60K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
6,254 |
2,716 |
$9K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
212 |
185 |
$7K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
85 |
77 |
$4K |
| V2750 |
Anti-reflective coating, per lens |
202 |
88 |
$4K |
| V2520 |
Contact lens, hydrophilic, spherical, per lens |
41 |
41 |
$4K |
| 92015 |
Determination of refractive state |
436 |
436 |
$2K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
26 |
26 |
$2K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
136 |
133 |
$1K |
| V2200 |
Sphere, bifocal, plano to plus or minus 4.00d, per lens |
24 |
12 |
$905.12 |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
13 |
13 |
$696.50 |
| 2023F |
|
39 |
38 |
$0.00 |