| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| V2782 |
Lens, index 1.54 to 1.65 plastic or 1.60 to 1.79 glass, excludes polycarbonate, per lens |
839 |
678 |
$89K |
| V2025 |
Deluxe frame |
1,392 |
1,267 |
$62K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
781 |
712 |
$52K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
471 |
440 |
$39K |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
2,214 |
2,049 |
$29K |
| V2760 |
Scratch resistant coating, per lens |
1,401 |
1,250 |
$22K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
1,177 |
1,055 |
$19K |
| V2020 |
Frames, purchases |
898 |
767 |
$16K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
250 |
224 |
$4K |
| V2104 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, 2.12 to 4.00d cylinder, per lens |
148 |
131 |
$2K |
| V2107 |
Spherocylinder, single vision, plus or minus 4.25 to plus or minus 7.00 sphere, .12 to 2.00d cylinder, per lens |
58 |
57 |
$1K |
| V2730 |
Special base curve, glass or plastic, per lens |
53 |
47 |
$947.92 |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
35 |
26 |
$468.93 |
| 92015 |
Determination of refractive state |
101 |
89 |
$242.64 |
| V2715 |
Prism, per lens |
419 |
380 |
$173.40 |
| V2756 |
Eye glass case |
14 |
13 |
$0.00 |