| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
1,613 |
1,513 |
$104K |
| V2020 |
Frames, purchases |
2,343 |
1,839 |
$50K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
292 |
238 |
$22K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
1,752 |
1,070 |
$20K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
492 |
404 |
$11K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
967 |
762 |
$5K |
| V2755 |
U-v lens, per lens |
521 |
456 |
$4K |
| 92370 |
|
30 |
29 |
$841.00 |
| 92015 |
Determination of refractive state |
2,141 |
1,985 |
$627.68 |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
29 |
14 |
$344.49 |
| V2203 |
Spherocylinder, bifocal, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
28 |
15 |
$270.00 |
| V2760 |
Scratch resistant coating, per lens |
14 |
14 |
$28.00 |