| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| V2020 |
Frames, purchases |
20,163 |
19,552 |
$1.01M |
| V2200 |
Sphere, bifocal, plano to plus or minus 4.00d, per lens |
7,987 |
7,719 |
$796K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
10,452 |
10,224 |
$740K |
| V2755 |
U-v lens, per lens |
20,274 |
19,650 |
$369K |
| V2760 |
Scratch resistant coating, per lens |
20,281 |
19,658 |
$277K |
| V2745 |
Addition to lens; tint, any color, solid, gradient or equal, excludes photochromatic, any lens material, per lens |
20,135 |
19,536 |
$147K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
927 |
810 |
$67K |
| 92250 |
|
1,686 |
1,609 |
$63K |
| V2107 |
Spherocylinder, single vision, plus or minus 4.25 to plus or minus 7.00 sphere, .12 to 2.00d cylinder, per lens |
543 |
533 |
$49K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
948 |
834 |
$39K |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
161 |
153 |
$13K |
| 92083 |
|
41 |
38 |
$2K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
17 |
12 |
$437.08 |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
14 |
12 |
$424.81 |
| 92133 |
|
22 |
15 |
$402.27 |