| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
9,381 |
4,494 |
$263K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
9,484 |
4,593 |
$192K |
| 92250 |
|
3,781 |
3,722 |
$173K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
2,032 |
1,956 |
$97K |
| V2020 |
Frames, purchases |
7,209 |
5,170 |
$91K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
2,087 |
2,023 |
$77K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
1,689 |
1,666 |
$76K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
815 |
803 |
$70K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
1,829 |
1,683 |
$57K |
| V2750 |
Anti-reflective coating, per lens |
1,166 |
523 |
$19K |
| 68761 |
|
401 |
225 |
$13K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
217 |
209 |
$9K |
| 92015 |
Determination of refractive state |
2,214 |
2,182 |
$9K |
| 92273 |
|
45 |
45 |
$4K |
| 95930 |
|
49 |
49 |
$3K |
| V2200 |
Sphere, bifocal, plano to plus or minus 4.00d, per lens |
67 |
39 |
$3K |
| V2760 |
Scratch resistant coating, per lens |
236 |
107 |
$2K |
| 92060 |
|
63 |
52 |
$2K |
| V2782 |
Lens, index 1.54 to 1.65 plastic or 1.60 to 1.79 glass, excludes polycarbonate, per lens |
14 |
14 |
$1K |
| 92065 |
|
39 |
13 |
$793.98 |
| V2744 |
Tint, photochromatic, per lens |
24 |
12 |
$720.00 |
| S0620 |
Routine ophthalmological examination including refraction; new patient |
12 |
12 |
$360.00 |
| V2781 |
Progressive lens, per lens |
18 |
12 |
$50.00 |
| G8427 |
Eligible clinician attests to documenting in the medical record they obtained, updated, or reviewed the patient's current medications |
291 |
248 |
$8.12 |
| 1036F |
|
209 |
181 |
$8.12 |
| 99307 |
|
12 |
12 |
$0.00 |