| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
1,782 |
1,561 |
$103K |
| V2020 |
Frames, purchases |
3,858 |
3,314 |
$47K |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
3,366 |
2,952 |
$38K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
2,158 |
1,814 |
$29K |
| V2203 |
Spherocylinder, bifocal, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
422 |
352 |
$19K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
770 |
650 |
$9K |
| V2107 |
Spherocylinder, single vision, plus or minus 4.25 to plus or minus 7.00 sphere, .12 to 2.00d cylinder, per lens |
306 |
274 |
$4K |
| V2104 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, 2.12 to 4.00d cylinder, per lens |
134 |
115 |
$2K |
| V2799 |
Vision item or service, miscellaneous |
94 |
94 |
$1K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
13 |
13 |
$1K |
| 92015 |
Determination of refractive state |
170 |
144 |
$345.19 |