| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
3,872 |
2,126 |
$65K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
1,546 |
1,541 |
$52K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
589 |
586 |
$48K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
772 |
749 |
$44K |
| V2020 |
Frames, purchases |
3,109 |
3,090 |
$32K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
497 |
257 |
$4K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
2,446 |
1,251 |
$945.00 |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
13 |
13 |
$730.34 |
| V2203 |
Spherocylinder, bifocal, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
19 |
12 |
$222.16 |
| V2755 |
U-v lens, per lens |
2,500 |
1,243 |
$0.00 |