| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| V2020 |
Frames, purchases |
3,300 |
3,243 |
$114K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
1,345 |
1,327 |
$91K |
| V2782 |
Lens, index 1.54 to 1.65 plastic or 1.60 to 1.79 glass, excludes polycarbonate, per lens |
2,339 |
2,322 |
$81K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
2,662 |
2,638 |
$79K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
718 |
703 |
$65K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
2,868 |
2,831 |
$54K |
| V2755 |
U-v lens, per lens |
2,347 |
2,332 |
$34K |
| 92015 |
Determination of refractive state |
3,211 |
3,131 |
$12K |
| V2760 |
Scratch resistant coating, per lens |
2,934 |
2,892 |
$6K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
616 |
591 |
$5K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
56 |
55 |
$4K |
| 92250 |
|
13 |
13 |
$637.13 |
| 92341 |
|
14 |
13 |
$165.00 |
| V2200 |
Sphere, bifocal, plano to plus or minus 4.00d, per lens |
14 |
13 |
$80.00 |