| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
3,285 |
3,284 |
$155K |
| V2020 |
Frames, purchases |
8,915 |
8,806 |
$51K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
6,686 |
3,853 |
$29K |
| V2520 |
Contact lens, hydrophilic, spherical, per lens |
593 |
593 |
$20K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
6,594 |
3,791 |
$18K |
| 92015 |
Determination of refractive state |
4,019 |
4,017 |
$15K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
184 |
184 |
$8K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
1,421 |
885 |
$5K |
| V2203 |
Spherocylinder, bifocal, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
1,170 |
683 |
$4K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
88 |
88 |
$2K |
| V2107 |
Spherocylinder, single vision, plus or minus 4.25 to plus or minus 7.00 sphere, .12 to 2.00d cylinder, per lens |
282 |
144 |
$147.00 |
| 3072F |
|
58 |
58 |
$0.00 |
| V2599 |
Contact lens, other type |
63 |
63 |
$0.00 |
| V2500 |
Contact lens, pmma, spherical, per lens |
271 |
271 |
$0.00 |