| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
6,905 |
6,716 |
$699K |
| V2020 |
Frames, purchases |
11,979 |
8,779 |
$434K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
16,442 |
6,324 |
$433K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
3,621 |
3,484 |
$432K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
15,765 |
10,165 |
$354K |
| V2025 |
Deluxe frame |
3,628 |
2,535 |
$337K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
16,141 |
10,347 |
$307K |
| V2104 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, 2.12 to 4.00d cylinder, per lens |
3,854 |
1,562 |
$132K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
2,586 |
1,196 |
$71K |
| V2745 |
Addition to lens; tint, any color, solid, gradient or equal, excludes photochromatic, any lens material, per lens |
361 |
331 |
$5K |
| V2105 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, 4.25 to 6.00d cylinder, per lens |
76 |
28 |
$3K |
| 92002 |
|
41 |
41 |
$3K |
| V2107 |
Spherocylinder, single vision, plus or minus 4.25 to plus or minus 7.00 sphere, .12 to 2.00d cylinder, per lens |
66 |
24 |
$2K |
| 92310 |
|
43 |
42 |
$2K |
| 92015 |
Determination of refractive state |
6,676 |
6,564 |
$1K |