| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92250 |
|
621 |
607 |
$43K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
539 |
500 |
$34K |
| 92015 |
Determination of refractive state |
1,120 |
1,094 |
$19K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
213 |
208 |
$19K |
| V2020 |
Frames, purchases |
358 |
245 |
$9K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
345 |
240 |
$7K |
| 92081 |
|
104 |
99 |
$3K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
27 |
27 |
$3K |
| V2200 |
Sphere, bifocal, plano to plus or minus 4.00d, per lens |
16 |
16 |
$924.00 |
| 92060 |
|
14 |
14 |
$494.32 |
| V2760 |
Scratch resistant coating, per lens |
97 |
96 |
$0.00 |
| V2750 |
Anti-reflective coating, per lens |
22 |
21 |
$0.00 |
| V2745 |
Addition to lens; tint, any color, solid, gradient or equal, excludes photochromatic, any lens material, per lens |
23 |
22 |
$0.00 |
| V2755 |
U-v lens, per lens |
111 |
110 |
$0.00 |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
52 |
51 |
$0.00 |
| V2782 |
Lens, index 1.54 to 1.65 plastic or 1.60 to 1.79 glass, excludes polycarbonate, per lens |
50 |
50 |
$0.00 |