| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
2,552 |
2,329 |
$145K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
1,483 |
1,342 |
$87K |
| V2499 |
Variable sphericity lens, other type |
1,213 |
1,133 |
$82K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
4,854 |
4,353 |
$66K |
| V2755 |
U-v lens, per lens |
3,245 |
2,912 |
$52K |
| V2750 |
Anti-reflective coating, per lens |
1,065 |
956 |
$51K |
| V2020 |
Frames, purchases |
4,845 |
4,346 |
$45K |
| 92015 |
Determination of refractive state |
4,024 |
3,603 |
$27K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
1,826 |
1,670 |
$26K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
3,527 |
3,195 |
$24K |
| V2104 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, 2.12 to 4.00d cylinder, per lens |
1,373 |
1,255 |
$17K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
241 |
212 |
$3K |
| V2782 |
Lens, index 1.54 to 1.65 plastic or 1.60 to 1.79 glass, excludes polycarbonate, per lens |
30 |
14 |
$2K |
| V2783 |
Lens, index greater than or equal to 1.66 plastic or greater than or equal to 1.80 glass, excludes polycarbonate, per lens |
24 |
12 |
$1K |
| V2204 |
Spherocylinder, bifocal, plano to plus or minus 4.00d sphere, 2.12 to 4.00d cylinder, per lens |
13 |
13 |
$270.00 |