| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
3,493 |
3,297 |
$127K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
2,462 |
2,290 |
$107K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
783 |
734 |
$53K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
541 |
502 |
$26K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
3,678 |
3,433 |
$19K |
| 92015 |
Determination of refractive state |
4,324 |
4,082 |
$18K |
| V2020 |
Frames, purchases |
2,894 |
2,683 |
$16K |
| V2104 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, 2.12 to 4.00d cylinder, per lens |
256 |
241 |
$9K |
| V2599 |
Contact lens, other type |
62 |
56 |
$8K |
| 92310 |
|
54 |
51 |
$200.00 |
| V2025 |
Deluxe frame |
1,182 |
1,117 |
$0.00 |
| V2750 |
Anti-reflective coating, per lens |
399 |
275 |
$0.00 |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
448 |
428 |
$0.00 |