| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| V2020 |
Frames, purchases |
7,562 |
7,113 |
$523K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
5,371 |
4,910 |
$513K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
2,618 |
2,400 |
$295K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
3,763 |
3,504 |
$204K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
5,972 |
5,663 |
$179K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
3,014 |
2,892 |
$129K |
| 92015 |
Determination of refractive state |
8,214 |
7,447 |
$128K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
1,296 |
1,233 |
$71K |
| V2203 |
Spherocylinder, bifocal, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
679 |
616 |
$61K |
| 92341 |
|
1,069 |
953 |
$33K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
373 |
318 |
$16K |
| V2745 |
Addition to lens; tint, any color, solid, gradient or equal, excludes photochromatic, any lens material, per lens |
574 |
543 |
$5K |
| V2104 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, 2.12 to 4.00d cylinder, per lens |
39 |
39 |
$2K |
| V2107 |
Spherocylinder, single vision, plus or minus 4.25 to plus or minus 7.00 sphere, .12 to 2.00d cylinder, per lens |
26 |
26 |
$2K |
| 92250 |
|
12 |
12 |
$818.84 |