| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
4,303 |
1,198 |
$116K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
3,029 |
2,995 |
$115K |
| V2020 |
Frames, purchases |
2,687 |
1,617 |
$77K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
1,139 |
1,128 |
$49K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
230 |
225 |
$9K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
174 |
146 |
$5K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
4,296 |
1,214 |
$3K |
| 92015 |
Determination of refractive state |
611 |
565 |
$2K |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
18 |
13 |
$481.03 |