| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
5,078 |
4,702 |
$384K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
3,911 |
3,658 |
$320K |
| V2020 |
Frames, purchases |
4,632 |
4,009 |
$148K |
| V2410 |
Variable asphericity lens, single vision, full field, glass or plastic, per lens |
1,761 |
1,505 |
$113K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
4,730 |
4,088 |
$111K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
3,003 |
2,596 |
$107K |
| V2750 |
Anti-reflective coating, per lens |
4,740 |
4,088 |
$93K |
| V2781 |
Progressive lens, per lens |
2,422 |
2,131 |
$89K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
4,859 |
4,174 |
$63K |
| V2744 |
Tint, photochromatic, per lens |
2,228 |
1,906 |
$29K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
126 |
111 |
$4K |
| V2104 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, 2.12 to 4.00d cylinder, per lens |
157 |
138 |
$3K |
| 92015 |
Determination of refractive state |
9,334 |
8,561 |
$3K |
| V2105 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, 4.25 to 6.00d cylinder, per lens |
13 |
12 |
$738.40 |