| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
4,197 |
3,978 |
$310K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
2,219 |
2,106 |
$163K |
| V2020 |
Frames, purchases |
6,498 |
5,878 |
$57K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
6,699 |
6,042 |
$39K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
5,003 |
4,479 |
$15K |
| 92015 |
Determination of refractive state |
5,574 |
5,311 |
$14K |
| 92341 |
|
52 |
49 |
$817.30 |
| V2203 |
Spherocylinder, bifocal, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
296 |
283 |
$349.00 |
| V2104 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, 2.12 to 4.00d cylinder, per lens |
63 |
62 |
$304.02 |
| V2107 |
Spherocylinder, single vision, plus or minus 4.25 to plus or minus 7.00 sphere, .12 to 2.00d cylinder, per lens |
35 |
34 |
$247.00 |
| V2755 |
U-v lens, per lens |
4,654 |
4,222 |
$29.00 |
| V2025 |
Deluxe frame |
139 |
106 |
$20.00 |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
173 |
152 |
$0.00 |