| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
2,421 |
1,805 |
$143K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
2,726 |
2,445 |
$132K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
1,314 |
1,306 |
$59K |
| V2020 |
Frames, purchases |
2,850 |
2,195 |
$26K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
489 |
486 |
$26K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
618 |
457 |
$21K |
| 92083 |
|
229 |
227 |
$13K |
| 92015 |
Determination of refractive state |
2,291 |
2,265 |
$12K |
| 92250 |
|
126 |
126 |
$6K |
| V2203 |
Spherocylinder, bifocal, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
148 |
110 |
$6K |
| 95930 |
|
30 |
29 |
$2K |
| 92133 |
|
17 |
17 |
$505.79 |
| V2750 |
Anti-reflective coating, per lens |
62 |
55 |
$450.00 |
| 92025 |
|
12 |
12 |
$241.34 |
| V2760 |
Scratch resistant coating, per lens |
342 |
291 |
$147.00 |