| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
7,788 |
7,688 |
$385K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
6,045 |
5,972 |
$293K |
| V2020 |
Frames, purchases |
10,915 |
10,817 |
$191K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
10,064 |
9,999 |
$177K |
| V2782 |
Lens, index 1.54 to 1.65 plastic or 1.60 to 1.79 glass, excludes polycarbonate, per lens |
1,347 |
1,319 |
$68K |
| 92015 |
Determination of refractive state |
4,333 |
4,266 |
$59K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
2,486 |
2,456 |
$51K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
6,506 |
6,457 |
$32K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
4,261 |
4,233 |
$25K |
| V2203 |
Spherocylinder, bifocal, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
331 |
327 |
$3K |
| V2104 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, 2.12 to 4.00d cylinder, per lens |
1,209 |
1,200 |
$2K |
| V2107 |
Spherocylinder, single vision, plus or minus 4.25 to plus or minus 7.00 sphere, .12 to 2.00d cylinder, per lens |
147 |
147 |
$224.16 |
| V2025 |
Deluxe frame |
45 |
45 |
$0.00 |