| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
8,291 |
4,208 |
$228K |
| 92250 |
|
4,114 |
4,060 |
$197K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
3,173 |
3,060 |
$161K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
7,567 |
3,801 |
$123K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
1,216 |
1,204 |
$105K |
| V2020 |
Frames, purchases |
5,922 |
4,812 |
$83K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
1,476 |
1,425 |
$57K |
| 95930 |
|
710 |
704 |
$51K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
757 |
728 |
$33K |
| 92273 |
|
341 |
339 |
$32K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
956 |
909 |
$29K |
| V2750 |
Anti-reflective coating, per lens |
1,698 |
861 |
$26K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
182 |
182 |
$10K |
| 76512 |
|
146 |
71 |
$9K |
| 92060 |
|
120 |
106 |
$4K |
| 92015 |
Determination of refractive state |
604 |
595 |
$3K |
| 92134 |
|
84 |
84 |
$2K |
| 99174 |
|
231 |
230 |
$2K |
| 92083 |
|
30 |
29 |
$2K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
31 |
13 |
$918.42 |
| V2744 |
Tint, photochromatic, per lens |
26 |
12 |
$780.00 |
| V2760 |
Scratch resistant coating, per lens |
96 |
44 |
$740.00 |
| 92283 |
|
39 |
39 |
$639.65 |