| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| V2020 |
Frames, purchases |
5,730 |
5,707 |
$183K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
1,003 |
1,001 |
$118K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
5,256 |
5,224 |
$111K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
2,999 |
2,841 |
$105K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
586 |
586 |
$77K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
4,642 |
2,895 |
$61K |
| V2025 |
Deluxe frame |
832 |
827 |
$32K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
2,314 |
1,505 |
$24K |
| 92341 |
|
339 |
336 |
$13K |
| V2200 |
Sphere, bifocal, plano to plus or minus 4.00d, per lens |
273 |
260 |
$13K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
65 |
57 |
$7K |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
84 |
84 |
$6K |
| 92015 |
Determination of refractive state |
1,182 |
1,181 |
$6K |
| V2104 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, 2.12 to 4.00d cylinder, per lens |
614 |
425 |
$4K |
| V2203 |
Spherocylinder, bifocal, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
269 |
164 |
$3K |
| V2105 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, 4.25 to 6.00d cylinder, per lens |
61 |
42 |
$593.53 |
| 92134 |
|
15 |
15 |
$534.75 |
| V2107 |
Spherocylinder, single vision, plus or minus 4.25 to plus or minus 7.00 sphere, .12 to 2.00d cylinder, per lens |
68 |
43 |
$401.28 |
| V2108 |
Spherocylinder, single vision, plus or minus 4.25d to plus or minus 7.00d sphere, 2.12 to 4.00d cylinder, per lens |
22 |
13 |
$133.76 |