| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
2,379 |
2,034 |
$123K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
1,683 |
1,612 |
$71K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
1,525 |
1,355 |
$66K |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
1,090 |
931 |
$49K |
| V2020 |
Frames, purchases |
1,374 |
1,335 |
$43K |
| 92015 |
Determination of refractive state |
2,207 |
2,169 |
$30K |
| V2025 |
Deluxe frame |
1,445 |
1,139 |
$22K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
836 |
796 |
$22K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
1,285 |
1,253 |
$14K |
| V2730 |
Special base curve, glass or plastic, per lens |
533 |
533 |
$11K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
706 |
694 |
$8K |
| S0620 |
Routine ophthalmological examination including refraction; new patient |
100 |
98 |
$4K |
| V2200 |
Sphere, bifocal, plano to plus or minus 4.00d, per lens |
42 |
25 |
$4K |
| S0621 |
Routine ophthalmological examination including refraction; established patient |
31 |
31 |
$1K |
| V2107 |
Spherocylinder, single vision, plus or minus 4.25 to plus or minus 7.00 sphere, .12 to 2.00d cylinder, per lens |
12 |
12 |
$127.60 |