| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| V2020 |
Frames, purchases |
1,750 |
1,676 |
$55K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
940 |
914 |
$39K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
1,225 |
1,183 |
$37K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
823 |
797 |
$34K |
| 92015 |
Determination of refractive state |
285 |
266 |
$5K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
219 |
200 |
$4K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
36 |
36 |
$2K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
190 |
171 |
$1K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
25 |
24 |
$440.00 |