| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
1,271 |
1,156 |
$139K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
1,230 |
1,142 |
$118K |
| V2105 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, 4.25 to 6.00d cylinder, per lens |
2,348 |
1,061 |
$86K |
| V2020 |
Frames, purchases |
1,462 |
1,294 |
$60K |
| V2410 |
Variable asphericity lens, single vision, full field, glass or plastic, per lens |
1,222 |
1,112 |
$58K |
| 92341 |
|
1,513 |
1,334 |
$36K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
511 |
462 |
$19K |
| V2102 |
Sphere, single vision, plus or minus 7.12 to plus or minus 20.00d, per lens |
314 |
133 |
$19K |
| V2750 |
Anti-reflective coating, per lens |
557 |
526 |
$8K |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
80 |
55 |
$4K |
| 92015 |
Determination of refractive state |
25 |
25 |
$344.90 |
| V2760 |
Scratch resistant coating, per lens |
30 |
28 |
$0.00 |