| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| V2020 |
Frames, purchases |
1,838 |
1,802 |
$106K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
1,443 |
1,425 |
$76K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
1,237 |
1,224 |
$75K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
2,094 |
2,053 |
$51K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
1,492 |
1,462 |
$50K |
| 92015 |
Determination of refractive state |
2,852 |
2,779 |
$46K |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
764 |
744 |
$32K |
| 92002 |
|
329 |
318 |
$14K |
| V2025 |
Deluxe frame |
2,255 |
2,204 |
$14K |
| V2105 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, 4.25 to 6.00d cylinder, per lens |
175 |
172 |
$7K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
94 |
94 |
$2K |
| V2104 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, 2.12 to 4.00d cylinder, per lens |
36 |
36 |
$1K |
| V2200 |
Sphere, bifocal, plano to plus or minus 4.00d, per lens |
13 |
13 |
$725.00 |
| V2205 |
Spherocylinder, bifocal, plano to plus or minus 4.00d sphere, 4.25 to 6.00d cylinder, per lens |
12 |
12 |
$580.80 |
| V2204 |
Spherocylinder, bifocal, plano to plus or minus 4.00d sphere, 2.12 to 4.00d cylinder, per lens |
12 |
12 |
$260.00 |