| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
2,245 |
2,221 |
$129K |
| V2020 |
Frames, purchases |
3,041 |
2,846 |
$51K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
2,140 |
1,995 |
$48K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
770 |
761 |
$44K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
1,855 |
1,674 |
$20K |
| V2200 |
Sphere, bifocal, plano to plus or minus 4.00d, per lens |
267 |
265 |
$10K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
322 |
285 |
$8K |
| 92015 |
Determination of refractive state |
3,090 |
3,051 |
$2K |
| V2203 |
Spherocylinder, bifocal, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
32 |
32 |
$1K |
| 92310 |
|
12 |
12 |
$504.00 |
| V2744 |
Tint, photochromatic, per lens |
15 |
15 |
$480.00 |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
27 |
27 |
$108.85 |