| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
2,254 |
2,144 |
$106K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
2,819 |
2,713 |
$89K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
1,069 |
1,025 |
$68K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
728 |
688 |
$25K |
| 92015 |
Determination of refractive state |
3,606 |
3,485 |
$22K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
3,181 |
3,036 |
$21K |
| V2020 |
Frames, purchases |
1,955 |
1,853 |
$19K |
| V2104 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, 2.12 to 4.00d cylinder, per lens |
193 |
178 |
$7K |
| V2203 |
Spherocylinder, bifocal, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
45 |
43 |
$3K |
| V2107 |
Spherocylinder, single vision, plus or minus 4.25 to plus or minus 7.00 sphere, .12 to 2.00d cylinder, per lens |
45 |
40 |
$3K |
| 92310 |
|
49 |
45 |
$200.00 |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
540 |
523 |
$0.00 |
| V2744 |
Tint, photochromatic, per lens |
18 |
18 |
$0.00 |
| 92341 |
|
81 |
79 |
$0.00 |
| V2750 |
Anti-reflective coating, per lens |
261 |
254 |
$0.00 |
| V2025 |
Deluxe frame |
1,749 |
1,677 |
$-116.00 |