| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
4,114 |
1,301 |
$112K |
| V2020 |
Frames, purchases |
2,304 |
1,516 |
$91K |
| 92250 |
|
1,495 |
1,446 |
$75K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
1,514 |
1,440 |
$73K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
813 |
789 |
$60K |
| 92083 |
|
400 |
381 |
$25K |
| V2750 |
Anti-reflective coating, per lens |
776 |
342 |
$19K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
369 |
351 |
$16K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
334 |
325 |
$14K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
4,476 |
1,436 |
$13K |
| 92133 |
|
110 |
105 |
$4K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
84 |
78 |
$3K |
| 76514 |
|
34 |
28 |
$310.22 |
| 92015 |
Determination of refractive state |
338 |
330 |
$11.50 |
| 2022F |
|
30 |
29 |
$0.00 |