| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
3,659 |
3,500 |
$168K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
3,110 |
2,966 |
$103K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
1,067 |
1,024 |
$77K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
882 |
837 |
$23K |
| V2020 |
Frames, purchases |
3,026 |
2,883 |
$19K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
4,255 |
4,055 |
$19K |
| 92015 |
Determination of refractive state |
4,600 |
4,421 |
$17K |
| V2104 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, 2.12 to 4.00d cylinder, per lens |
219 |
194 |
$8K |
| V2599 |
Contact lens, other type |
60 |
57 |
$8K |
| V2107 |
Spherocylinder, single vision, plus or minus 4.25 to plus or minus 7.00 sphere, .12 to 2.00d cylinder, per lens |
71 |
67 |
$2K |
| 92341 |
|
16 |
13 |
$14.50 |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
341 |
317 |
$0.00 |
| 92310 |
|
60 |
57 |
$0.00 |
| V2750 |
Anti-reflective coating, per lens |
212 |
194 |
$0.00 |
| V2025 |
Deluxe frame |
1,548 |
1,476 |
$-116.00 |