| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
4,661 |
4,314 |
$125K |
| V2020 |
Frames, purchases |
6,231 |
5,784 |
$107K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
3,108 |
2,939 |
$60K |
| S0620 |
Routine ophthalmological examination including refraction; new patient |
771 |
771 |
$39K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
1,333 |
1,158 |
$25K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
650 |
577 |
$23K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
936 |
928 |
$22K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
3,188 |
2,937 |
$21K |
| V2203 |
Spherocylinder, bifocal, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
608 |
566 |
$17K |
| 92341 |
|
86 |
86 |
$3K |
| V2200 |
Sphere, bifocal, plano to plus or minus 4.00d, per lens |
52 |
51 |
$2K |
| V2303 |
Spherocylinder, trifocal, plano to plus or minus 4.00d sphere, .12-2.00d cylinder, per lens |
39 |
39 |
$1K |
| 92015 |
Determination of refractive state |
40 |
39 |
$722.76 |
| V2781 |
Progressive lens, per lens |
31 |
29 |
$515.00 |