| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
2,581 |
2,486 |
$151K |
| V2020 |
Frames, purchases |
4,038 |
3,494 |
$100K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
1,368 |
1,306 |
$96K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
3,321 |
1,954 |
$14K |
| 92015 |
Determination of refractive state |
4,300 |
4,069 |
$14K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
1,468 |
1,378 |
$11K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
1,685 |
888 |
$7K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
1,262 |
1,197 |
$3K |
| V2203 |
Spherocylinder, bifocal, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
168 |
97 |
$485.65 |
| V2104 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, 2.12 to 4.00d cylinder, per lens |
40 |
25 |
$249.88 |
| 92310 |
|
17 |
12 |
$35.00 |
| V2025 |
Deluxe frame |
128 |
124 |
$0.00 |
| V2760 |
Scratch resistant coating, per lens |
49 |
43 |
$0.00 |
| V2755 |
U-v lens, per lens |
1,529 |
1,326 |
$0.00 |