| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
1,855 |
1,724 |
$56K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
1,307 |
1,200 |
$54K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
850 |
790 |
$49K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
629 |
567 |
$27K |
| V2020 |
Frames, purchases |
2,110 |
1,925 |
$18K |
| 92015 |
Determination of refractive state |
2,706 |
2,521 |
$10K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
2,243 |
2,055 |
$9K |
| V2599 |
Contact lens, other type |
12 |
12 |
$1K |
| V2104 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, 2.12 to 4.00d cylinder, per lens |
43 |
38 |
$1K |
| V2203 |
Spherocylinder, bifocal, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
14 |
14 |
$958.00 |
| 92341 |
|
95 |
84 |
$0.00 |
| V2750 |
Anti-reflective coating, per lens |
72 |
60 |
$0.00 |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
137 |
133 |
$0.00 |
| 92310 |
|
24 |
24 |
$0.00 |
| V2025 |
Deluxe frame |
499 |
460 |
$-124.00 |