| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
4,527 |
4,080 |
$191K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
2,039 |
1,809 |
$106K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
3,557 |
2,920 |
$89K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
1,857 |
1,487 |
$47K |
| V2020 |
Frames, purchases |
4,501 |
3,828 |
$30K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
5,426 |
4,510 |
$27K |
| 92015 |
Determination of refractive state |
6,125 |
5,459 |
$27K |
| V2599 |
Contact lens, other type |
64 |
63 |
$9K |
| V2104 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, 2.12 to 4.00d cylinder, per lens |
219 |
165 |
$6K |
| V2203 |
Spherocylinder, bifocal, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
61 |
53 |
$2K |
| V2107 |
Spherocylinder, single vision, plus or minus 4.25 to plus or minus 7.00 sphere, .12 to 2.00d cylinder, per lens |
30 |
25 |
$1K |
| 92310 |
|
134 |
131 |
$180.00 |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
269 |
240 |
$149.00 |
| 92341 |
|
60 |
53 |
$14.50 |
| V2756 |
Eye glass case |
77 |
77 |
$0.00 |
| 92342 |
|
77 |
77 |
$0.00 |
| V2750 |
Anti-reflective coating, per lens |
55 |
45 |
$0.00 |
| 2021F |
|
73 |
73 |
$0.00 |
| V2025 |
Deluxe frame |
1,650 |
1,394 |
$-181.00 |