| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
7,038 |
6,123 |
$312K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
3,082 |
2,724 |
$156K |
| V2020 |
Frames, purchases |
11,079 |
9,583 |
$131K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
8,296 |
7,132 |
$127K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
10,916 |
9,450 |
$88K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
217 |
213 |
$36K |
| V2104 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, 2.12 to 4.00d cylinder, per lens |
1,638 |
1,426 |
$19K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
7,857 |
6,516 |
$16K |
| V2410 |
Variable asphericity lens, single vision, full field, glass or plastic, per lens |
4,981 |
4,284 |
$14K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
897 |
792 |
$12K |
| V2107 |
Spherocylinder, single vision, plus or minus 4.25 to plus or minus 7.00 sphere, .12 to 2.00d cylinder, per lens |
745 |
648 |
$10K |
| V2105 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, 4.25 to 6.00d cylinder, per lens |
91 |
79 |
$867.50 |
| V2108 |
Spherocylinder, single vision, plus or minus 4.25d to plus or minus 7.00d sphere, 2.12 to 4.00d cylinder, per lens |
49 |
42 |
$542.50 |
| 92015 |
Determination of refractive state |
7,401 |
6,221 |
$28.33 |