| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
2,434 |
2,034 |
$150K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
2,802 |
2,447 |
$70K |
| V2020 |
Frames, purchases |
3,259 |
2,900 |
$70K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
295 |
285 |
$26K |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
2,081 |
2,038 |
$24K |
| 92015 |
Determination of refractive state |
1,431 |
1,083 |
$6K |
| V2025 |
Deluxe frame |
269 |
152 |
$6K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
95 |
49 |
$1K |
| V2799 |
Vision item or service, miscellaneous |
148 |
146 |
$1K |
| V2200 |
Sphere, bifocal, plano to plus or minus 4.00d, per lens |
13 |
12 |
$1K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
28 |
27 |
$183.20 |