| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| V2020 |
Frames, purchases |
3,289 |
3,152 |
$101K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
2,094 |
2,007 |
$61K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
1,246 |
1,202 |
$52K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
890 |
859 |
$37K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
733 |
698 |
$14K |
| 92015 |
Determination of refractive state |
678 |
648 |
$13K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
292 |
272 |
$5K |
| V2200 |
Sphere, bifocal, plano to plus or minus 4.00d, per lens |
88 |
88 |
$4K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
638 |
610 |
$4K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
58 |
55 |
$4K |
| 92060 |
|
54 |
53 |
$3K |
| 92250 |
|
28 |
28 |
$2K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
14 |
14 |
$1K |