| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| V2410 |
Variable asphericity lens, single vision, full field, glass or plastic, per lens |
5,520 |
4,606 |
$587K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
5,190 |
4,430 |
$433K |
| V2020 |
Frames, purchases |
7,351 |
6,144 |
$266K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
2,286 |
2,024 |
$247K |
| V2755 |
U-v lens, per lens |
8,054 |
6,663 |
$168K |
| V2200 |
Sphere, bifocal, plano to plus or minus 4.00d, per lens |
2,009 |
1,657 |
$145K |
| 92015 |
Determination of refractive state |
8,448 |
7,260 |
$119K |
| 92250 |
|
1,349 |
1,124 |
$42K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
321 |
271 |
$21K |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
254 |
214 |
$14K |
| V2715 |
Prism, per lens |
353 |
283 |
$5K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
14 |
12 |
$1K |
| 92083 |
|
13 |
12 |
$678.45 |