| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
|
2,283 |
2,035 |
$94K |
| 92015 |
|
3,129 |
2,799 |
$65K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
2,958 |
2,552 |
$57K |
| 92004 |
|
800 |
738 |
$47K |
| 92250 |
|
2,137 |
2,009 |
$39K |
| 92340 |
|
1,121 |
858 |
$24K |
| V2020 |
Frames, purchases |
2,972 |
2,580 |
$22K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
988 |
955 |
$16K |
| 99213 |
|
448 |
388 |
$7K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
1,185 |
884 |
$6K |
| 99214 |
|
14 |
13 |
$444.37 |
| S9986 |
Not medically necessary service (patient is aware that service not medically necessary) |
125 |
120 |
$102.40 |
| V2200 |
Sphere, bifocal, plano to plus or minus 4.00d, per lens |
25 |
25 |
$37.80 |
| V2781 |
Progressive lens, per lens |
50 |
50 |
$0.00 |
| 2033F |
|
16 |
16 |
$0.00 |
| G8428 |
Current list of medications not documented as obtained, updated, or reviewed by the eligible clinician, reason not given |
27 |
26 |
$0.00 |
| V2744 |
Tint, photochromatic, per lens |
29 |
27 |
$0.00 |
| V2750 |
Anti-reflective coating, per lens |
228 |
188 |
$0.00 |