| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| V2020 |
Frames, purchases |
1,269 |
1,233 |
$44K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
396 |
386 |
$34K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
626 |
606 |
$16K |
| 92015 |
Determination of refractive state |
1,107 |
1,083 |
$15K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
1,064 |
1,038 |
$13K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
57 |
57 |
$7K |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
72 |
70 |
$5K |
| 92002 |
|
15 |
13 |
$878.15 |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
30 |
28 |
$700.76 |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
13 |
13 |
$319.19 |
| V2755 |
U-v lens, per lens |
1,264 |
1,231 |
$0.00 |