| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
3,136 |
2,944 |
$145K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
1,857 |
1,743 |
$117K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
2,163 |
1,999 |
$56K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
1,366 |
1,248 |
$32K |
| V2020 |
Frames, purchases |
4,149 |
3,880 |
$24K |
| V2203 |
Spherocylinder, bifocal, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
465 |
415 |
$20K |
| 92015 |
Determination of refractive state |
4,703 |
4,423 |
$18K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
3,625 |
3,395 |
$17K |
| V2200 |
Sphere, bifocal, plano to plus or minus 4.00d, per lens |
89 |
75 |
$3K |
| 92341 |
|
775 |
711 |
$2K |
| V2104 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, 2.12 to 4.00d cylinder, per lens |
26 |
25 |
$777.50 |
| V2107 |
Spherocylinder, single vision, plus or minus 4.25 to plus or minus 7.00 sphere, .12 to 2.00d cylinder, per lens |
18 |
17 |
$774.50 |
| V2025 |
Deluxe frame |
441 |
408 |
$0.00 |
| V2750 |
Anti-reflective coating, per lens |
217 |
207 |
$0.00 |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
374 |
356 |
$0.00 |
| 92310 |
|
38 |
38 |
$0.00 |
| V2756 |
Eye glass case |
16 |
16 |
$0.00 |
| 92342 |
|
16 |
16 |
$0.00 |