| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
6,322 |
5,941 |
$484K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
3,244 |
3,067 |
$203K |
| V2020 |
Frames, purchases |
6,655 |
6,026 |
$48K |
| 92015 |
Determination of refractive state |
9,598 |
9,035 |
$34K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
4,350 |
3,922 |
$26K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
6,233 |
5,637 |
$23K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
4,894 |
4,481 |
$6K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
885 |
795 |
$5K |
| V2104 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, 2.12 to 4.00d cylinder, per lens |
1,008 |
911 |
$5K |
| 92341 |
|
70 |
56 |
$450.00 |
| V2107 |
Spherocylinder, single vision, plus or minus 4.25 to plus or minus 7.00 sphere, .12 to 2.00d cylinder, per lens |
40 |
28 |
$323.69 |
| 3072F |
|
109 |
103 |
$217.87 |
| V2105 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, 4.25 to 6.00d cylinder, per lens |
30 |
24 |
$188.79 |
| V2203 |
Spherocylinder, bifocal, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
15 |
15 |
$164.43 |