| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
3,229 |
3,084 |
$313K |
| V2020 |
Frames, purchases |
5,823 |
5,095 |
$252K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
1,999 |
1,906 |
$240K |
| V2025 |
Deluxe frame |
2,635 |
2,315 |
$225K |
| V2410 |
Variable asphericity lens, single vision, full field, glass or plastic, per lens |
1,163 |
987 |
$190K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
5,521 |
4,831 |
$181K |
| V2750 |
Anti-reflective coating, per lens |
4,360 |
3,795 |
$120K |
| V2755 |
U-v lens, per lens |
3,931 |
3,437 |
$117K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
5,040 |
4,359 |
$96K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
1,016 |
905 |
$53K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
250 |
226 |
$31K |
| 92015 |
Determination of refractive state |
6,446 |
6,204 |
$17K |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
51 |
29 |
$2K |
| V2104 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, 2.12 to 4.00d cylinder, per lens |
33 |
31 |
$2K |