| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| V2020 |
Frames, purchases |
3,209 |
3,174 |
$135K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
2,062 |
2,059 |
$118K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
461 |
461 |
$26K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
2,268 |
2,157 |
$18K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
462 |
224 |
$9K |
| 92250 |
|
99 |
99 |
$2K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
772 |
400 |
$500.00 |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
12 |
12 |
$49.61 |