| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
5,256 |
4,773 |
$314K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
3,996 |
3,989 |
$225K |
| 92015 |
Determination of refractive state |
7,652 |
7,616 |
$225K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
2,929 |
2,909 |
$173K |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
2,568 |
1,290 |
$116K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
5,580 |
5,070 |
$87K |
| V2020 |
Frames, purchases |
5,042 |
4,629 |
$77K |
| 92065 |
|
2,291 |
727 |
$72K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
6,235 |
5,723 |
$38K |
| V2500 |
Contact lens, pmma, spherical, per lens |
557 |
557 |
$30K |
| V2755 |
U-v lens, per lens |
944 |
940 |
$24K |
| V2783 |
Lens, index greater than or equal to 1.66 plastic or greater than or equal to 1.80 glass, excludes polycarbonate, per lens |
158 |
158 |
$17K |
| 92060 |
|
232 |
232 |
$9K |
| 92310 |
|
101 |
101 |
$6K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
22 |
22 |
$1K |
| V2200 |
Sphere, bifocal, plano to plus or minus 4.00d, per lens |
12 |
12 |
$234.00 |
| 2023F |
|
1,302 |
1,302 |
$0.00 |
| 3072F |
|
778 |
726 |
$0.00 |