| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
2,966 |
1,672 |
$130K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
2,819 |
2,206 |
$113K |
| V2020 |
Frames, purchases |
2,922 |
2,146 |
$56K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
515 |
256 |
$20K |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
369 |
306 |
$15K |
| 92083 |
|
189 |
178 |
$10K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
175 |
163 |
$9K |
| 92015 |
Determination of refractive state |
1,070 |
704 |
$9K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
121 |
105 |
$5K |
| 92250 |
|
41 |
39 |
$2K |
| V2025 |
Deluxe frame |
111 |
98 |
$1K |