| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
1,280 |
532 |
$44K |
| V2020 |
Frames, purchases |
799 |
584 |
$40K |
| 92250 |
|
567 |
563 |
$31K |
| 92083 |
|
353 |
350 |
$23K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
549 |
511 |
$23K |
| V2200 |
Sphere, bifocal, plano to plus or minus 4.00d, per lens |
213 |
131 |
$11K |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
235 |
235 |
$9K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
205 |
202 |
$9K |
| V2025 |
Deluxe frame |
222 |
214 |
$3K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
62 |
61 |
$2K |
| 92133 |
|
26 |
26 |
$944.79 |
| 92015 |
Determination of refractive state |
176 |
176 |
$625.50 |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
56 |
56 |
$560.00 |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
701 |
212 |
$472.00 |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
13 |
13 |
$360.00 |
| 92285 |
|
14 |
14 |
$176.87 |