| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
3,269 |
3,100 |
$295K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
1,438 |
1,360 |
$157K |
| V2410 |
Variable asphericity lens, single vision, full field, glass or plastic, per lens |
1,322 |
573 |
$95K |
| V2020 |
Frames, purchases |
1,806 |
1,570 |
$75K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
3,727 |
1,609 |
$47K |
| V2750 |
Anti-reflective coating, per lens |
3,182 |
1,393 |
$44K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
1,585 |
833 |
$40K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
1,785 |
1,554 |
$35K |
| 92310 |
|
673 |
649 |
$12K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
205 |
178 |
$10K |
| V2104 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, 2.12 to 4.00d cylinder, per lens |
239 |
148 |
$7K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
139 |
65 |
$3K |
| V2521 |
Contact lens, hydrophilic, toric, or prism ballast, per lens |
26 |
14 |
$2K |
| 92015 |
Determination of refractive state |
4,738 |
4,488 |
$2K |
| V2107 |
Spherocylinder, single vision, plus or minus 4.25 to plus or minus 7.00 sphere, .12 to 2.00d cylinder, per lens |
29 |
12 |
$876.82 |
| V2745 |
Addition to lens; tint, any color, solid, gradient or equal, excludes photochromatic, any lens material, per lens |
30 |
14 |
$153.16 |