| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
8,043 |
7,530 |
$977K |
| V2410 |
Variable asphericity lens, single vision, full field, glass or plastic, per lens |
3,997 |
3,648 |
$722K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
4,214 |
3,990 |
$302K |
| V2025 |
Deluxe frame |
2,244 |
2,155 |
$148K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
2,450 |
2,222 |
$147K |
| V2750 |
Anti-reflective coating, per lens |
4,373 |
4,139 |
$129K |
| V2755 |
U-v lens, per lens |
4,114 |
3,926 |
$118K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
4,370 |
4,132 |
$109K |
| V2020 |
Frames, purchases |
1,761 |
1,637 |
$106K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
966 |
945 |
$102K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
288 |
272 |
$20K |
| 92015 |
Determination of refractive state |
9,606 |
9,007 |
$16K |
| V2104 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, 2.12 to 4.00d cylinder, per lens |
195 |
177 |
$12K |
| 92250 |
|
13 |
13 |
$508.10 |