| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| V2020 |
Frames, purchases |
1,595 |
1,547 |
$51K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
1,114 |
1,086 |
$35K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
746 |
711 |
$31K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
656 |
628 |
$27K |
| 92015 |
Determination of refractive state |
202 |
191 |
$4K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
174 |
165 |
$3K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
141 |
134 |
$888.50 |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
14 |
13 |
$881.66 |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
12 |
12 |
$190.00 |