| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
11,660 |
6,146 |
$413K |
| V2020 |
Frames, purchases |
9,124 |
8,134 |
$266K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
5,977 |
5,644 |
$171K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
3,295 |
3,246 |
$139K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
2,613 |
2,565 |
$123K |
| 68761 |
|
3,334 |
1,596 |
$123K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
1,300 |
1,268 |
$102K |
| 92250 |
|
2,082 |
2,036 |
$92K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
1,946 |
1,907 |
$79K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
9,691 |
4,469 |
$45K |
| 92083 |
|
774 |
766 |
$42K |
| 92015 |
Determination of refractive state |
5,851 |
5,750 |
$27K |
| 92133 |
|
721 |
711 |
$21K |
| V2750 |
Anti-reflective coating, per lens |
659 |
363 |
$9K |
| V2200 |
Sphere, bifocal, plano to plus or minus 4.00d, per lens |
112 |
67 |
$5K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
96 |
94 |
$960.00 |
| V2755 |
U-v lens, per lens |
124 |
60 |
$672.00 |
| V2025 |
Deluxe frame |
45 |
44 |
$534.60 |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
12 |
12 |
$480.00 |
| 92134 |
|
12 |
12 |
$349.57 |