| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
2,515 |
2,204 |
$134K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
1,887 |
1,756 |
$85K |
| V2020 |
Frames, purchases |
3,087 |
2,706 |
$40K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
1,499 |
1,349 |
$33K |
| 92015 |
Determination of refractive state |
3,755 |
3,452 |
$21K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
2,604 |
2,309 |
$20K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
588 |
515 |
$11K |
| V2314 |
Spherocylinder, trifocal, sphere over plus or minus 12.00d, per lens |
411 |
321 |
$6K |
| 92341 |
|
660 |
608 |
$5K |
| V2025 |
Deluxe frame |
605 |
568 |
$3K |
| V2313 |
Spherocylinder, trifocal, plus or minus 7.25 to plus or minus 12.00d sphere, 4.25 to 6.00d cylinder, per lens |
261 |
238 |
$1K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
100 |
93 |
$308.24 |
| 92082 |
|
16 |
13 |
$120.00 |
| V2213 |
Spherocylinder, bifocal, plus or minus 7.25 to plus or minus 12.00d sphere, 4.25 to 6.00d cylinder, per lens |
66 |
43 |
$56.12 |
| V2114 |
Spherocylinder, single vision, sphere over plus or minus 12.00d, per lens |
33 |
22 |
$0.00 |
| V2214 |
Spherocylinder, bifocal, sphere over plus or minus 12.00d, per lens |
51 |
30 |
$0.00 |
| V2113 |
Spherocylinder, single vision, plus or minus 7.25 to plus or minus 12.00d sphere, 4.25 to 6.00d cylinder, per lens |
33 |
22 |
$0.00 |