| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
3,547 |
3,400 |
$149K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
3,257 |
3,092 |
$123K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
1,391 |
1,320 |
$100K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
4,167 |
3,954 |
$19K |
| V2020 |
Frames, purchases |
3,104 |
2,951 |
$19K |
| 92015 |
Determination of refractive state |
4,699 |
4,509 |
$18K |
| V2104 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, 2.12 to 4.00d cylinder, per lens |
258 |
247 |
$7K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
188 |
180 |
$4K |
| V2203 |
Spherocylinder, bifocal, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
44 |
42 |
$3K |
| V2107 |
Spherocylinder, single vision, plus or minus 4.25 to plus or minus 7.00 sphere, .12 to 2.00d cylinder, per lens |
83 |
78 |
$3K |
| 92310 |
|
39 |
38 |
$100.00 |
| 92341 |
|
46 |
44 |
$0.00 |
| V2750 |
Anti-reflective coating, per lens |
237 |
227 |
$0.00 |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
467 |
448 |
$0.00 |
| V2025 |
Deluxe frame |
1,459 |
1,389 |
$-240.00 |