| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
2,795 |
2,387 |
$150K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
1,876 |
1,850 |
$85K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
949 |
937 |
$55K |
| V2020 |
Frames, purchases |
2,821 |
2,417 |
$39K |
| V2102 |
Sphere, single vision, plus or minus 7.12 to plus or minus 20.00d, per lens |
773 |
698 |
$31K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
764 |
621 |
$22K |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
485 |
472 |
$14K |
| 92015 |
Determination of refractive state |
2,312 |
2,272 |
$12K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
451 |
379 |
$12K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
268 |
261 |
$9K |
| V2104 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, 2.12 to 4.00d cylinder, per lens |
302 |
237 |
$8K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
118 |
118 |
$6K |
| 92060 |
|
72 |
72 |
$2K |
| S0621 |
Routine ophthalmological examination including refraction; established patient |
67 |
67 |
$2K |