| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
2,403 |
2,217 |
$229K |
| V2410 |
Variable asphericity lens, single vision, full field, glass or plastic, per lens |
1,707 |
1,521 |
$216K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
1,245 |
1,123 |
$134K |
| 92250 |
|
3,917 |
3,516 |
$132K |
| V2025 |
Deluxe frame |
997 |
881 |
$102K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
2,136 |
1,929 |
$56K |
| V2750 |
Anti-reflective coating, per lens |
2,168 |
1,955 |
$51K |
| V2020 |
Frames, purchases |
964 |
900 |
$43K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
1,026 |
934 |
$39K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
2,160 |
1,943 |
$34K |
| V2104 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, 2.12 to 4.00d cylinder, per lens |
46 |
40 |
$2K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
18 |
18 |
$763.20 |
| V2107 |
Spherocylinder, single vision, plus or minus 4.25 to plus or minus 7.00 sphere, .12 to 2.00d cylinder, per lens |
12 |
12 |
$525.00 |
| 92015 |
Determination of refractive state |
4,663 |
4,205 |
$440.17 |