| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| V2020 |
Frames, purchases |
3,873 |
3,720 |
$247K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
2,034 |
1,963 |
$173K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
1,268 |
1,210 |
$123K |
| S0580 |
Polycarbonate lens (list this code in addition to the basic code for the lens) |
3,914 |
3,748 |
$94K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
2,639 |
2,526 |
$91K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
620 |
588 |
$14K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
238 |
224 |
$13K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
80 |
78 |
$5K |
| V2104 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, 2.12 to 4.00d cylinder, per lens |
43 |
41 |
$971.25 |
| V2107 |
Spherocylinder, single vision, plus or minus 4.25 to plus or minus 7.00 sphere, .12 to 2.00d cylinder, per lens |
13 |
12 |
$359.98 |