| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
1,755 |
1,731 |
$80K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
1,185 |
1,164 |
$62K |
| V2020 |
Frames, purchases |
2,487 |
2,418 |
$50K |
| S0621 |
Routine ophthalmological examination including refraction; established patient |
566 |
553 |
$32K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
237 |
237 |
$10K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
592 |
539 |
$9K |
| 92015 |
Determination of refractive state |
629 |
590 |
$6K |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
100 |
94 |
$5K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
307 |
282 |
$3K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
28 |
26 |
$1K |
| V2025 |
Deluxe frame |
65 |
65 |
$772.20 |
| S0620 |
Routine ophthalmological examination including refraction; new patient |
13 |
13 |
$0.00 |