| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
849 |
682 |
$48K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
366 |
359 |
$16K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
302 |
296 |
$15K |
| V2020 |
Frames, purchases |
292 |
292 |
$10K |
| V2203 |
Spherocylinder, bifocal, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
115 |
115 |
$10K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
77 |
76 |
$6K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
82 |
82 |
$5K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
43 |
43 |
$3K |
| V2104 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, 2.12 to 4.00d cylinder, per lens |
14 |
14 |
$950.00 |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
26 |
26 |
$652.62 |