| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| V2020 |
Frames, purchases |
2,853 |
2,782 |
$67K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
1,349 |
1,322 |
$65K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
1,192 |
1,162 |
$56K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
1,437 |
1,401 |
$39K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
1,740 |
1,719 |
$28K |
| 92015 |
Determination of refractive state |
740 |
729 |
$9K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
820 |
809 |
$7K |
| 92250 |
|
56 |
56 |
$4K |
| V2025 |
Deluxe frame |
69 |
68 |
$3K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
29 |
28 |
$2K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
726 |
720 |
$1K |
| 92060 |
|
13 |
13 |
$803.27 |
| V2200 |
Sphere, bifocal, plano to plus or minus 4.00d, per lens |
12 |
12 |
$693.00 |
| V2107 |
Spherocylinder, single vision, plus or minus 4.25 to plus or minus 7.00 sphere, .12 to 2.00d cylinder, per lens |
25 |
25 |
$175.00 |