| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
3,197 |
3,005 |
$169K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
1,477 |
1,413 |
$107K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
3,145 |
2,861 |
$67K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
850 |
761 |
$14K |
| V2020 |
Frames, purchases |
3,484 |
3,266 |
$11K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
4,171 |
3,885 |
$7K |
| V2599 |
Contact lens, other type |
26 |
24 |
$2K |
| V2203 |
Spherocylinder, bifocal, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
109 |
97 |
$2K |
| V2104 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, 2.12 to 4.00d cylinder, per lens |
166 |
151 |
$2K |
| V2107 |
Spherocylinder, single vision, plus or minus 4.25 to plus or minus 7.00 sphere, .12 to 2.00d cylinder, per lens |
80 |
75 |
$1K |
| 92015 |
Determination of refractive state |
4,335 |
4,081 |
$904.25 |
| 92310 |
|
68 |
65 |
$200.00 |
| 92341 |
|
161 |
147 |
$43.50 |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
383 |
361 |
$0.00 |
| V2756 |
Eye glass case |
12 |
12 |
$0.00 |
| 92342 |
|
12 |
12 |
$0.00 |
| V2025 |
Deluxe frame |
971 |
893 |
$0.00 |
| V2750 |
Anti-reflective coating, per lens |
99 |
96 |
$0.00 |