| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
6,895 |
3,131 |
$185K |
| V2020 |
Frames, purchases |
3,854 |
3,455 |
$155K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
3,117 |
2,989 |
$152K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
3,406 |
3,337 |
$145K |
| 92083 |
|
1,326 |
1,292 |
$84K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
1,653 |
1,609 |
$71K |
| 92250 |
|
1,207 |
1,179 |
$63K |
| V2520 |
Contact lens, hydrophilic, spherical, per lens |
618 |
577 |
$48K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
441 |
425 |
$15K |
| 92310 |
|
220 |
219 |
$13K |
| 92015 |
Determination of refractive state |
654 |
634 |
$8K |
| 92132 |
|
253 |
252 |
$7K |
| 92020 |
|
79 |
77 |
$1K |
| 92133 |
|
39 |
39 |
$1K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
6,522 |
2,852 |
$1K |
| 76514 |
|
101 |
99 |
$948.11 |
| V2750 |
Anti-reflective coating, per lens |
26 |
12 |
$490.00 |