| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
5,109 |
4,972 |
$527K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
3,691 |
3,301 |
$260K |
| V2025 |
Deluxe frame |
2,582 |
2,576 |
$179K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
6,836 |
6,736 |
$135K |
| V2020 |
Frames, purchases |
4,911 |
4,803 |
$132K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
2,449 |
2,418 |
$98K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
2,601 |
2,551 |
$80K |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
1,237 |
1,116 |
$69K |
| 92015 |
Determination of refractive state |
5,233 |
5,107 |
$31K |
| V2104 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, 2.12 to 4.00d cylinder, per lens |
319 |
318 |
$11K |
| V2203 |
Spherocylinder, bifocal, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
193 |
184 |
$10K |
| 92370 |
|
527 |
526 |
$8K |
| 92341 |
|
232 |
229 |
$8K |
| V2107 |
Spherocylinder, single vision, plus or minus 4.25 to plus or minus 7.00 sphere, .12 to 2.00d cylinder, per lens |
174 |
172 |
$6K |
| V2200 |
Sphere, bifocal, plano to plus or minus 4.00d, per lens |
57 |
57 |
$3K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
67 |
62 |
$1K |
| V2299 |
Specialty bifocal (by report) |
16 |
15 |
$1K |
| V2108 |
Spherocylinder, single vision, plus or minus 4.25d to plus or minus 7.00d sphere, 2.12 to 4.00d cylinder, per lens |
12 |
12 |
$464.75 |