| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
16,279 |
14,925 |
$758K |
| V2020 |
Frames, purchases |
19,671 |
19,056 |
$721K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
7,735 |
7,352 |
$502K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
12,267 |
11,402 |
$421K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
4,214 |
4,095 |
$335K |
| V2744 |
Tint, photochromatic, per lens |
4,565 |
4,493 |
$130K |
| 92015 |
Determination of refractive state |
17,326 |
16,318 |
$82K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
1,731 |
1,647 |
$47K |
| V2104 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, 2.12 to 4.00d cylinder, per lens |
957 |
919 |
$40K |
| V2203 |
Spherocylinder, bifocal, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
1,170 |
668 |
$32K |
| V2107 |
Spherocylinder, single vision, plus or minus 4.25 to plus or minus 7.00 sphere, .12 to 2.00d cylinder, per lens |
295 |
277 |
$13K |
| V2303 |
Spherocylinder, trifocal, plano to plus or minus 4.00d sphere, .12-2.00d cylinder, per lens |
166 |
97 |
$8K |
| 92250 |
|
405 |
400 |
$6K |
| V2781 |
Progressive lens, per lens |
167 |
87 |
$4K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
49 |
37 |
$1K |