| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
2,194 |
2,057 |
$95K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
1,276 |
1,183 |
$77K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
1,902 |
1,748 |
$56K |
| V2020 |
Frames, purchases |
2,310 |
2,134 |
$22K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
2,714 |
2,486 |
$19K |
| 92015 |
Determination of refractive state |
3,416 |
3,202 |
$17K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
634 |
564 |
$16K |
| V2203 |
Spherocylinder, bifocal, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
153 |
135 |
$7K |
| 92341 |
|
256 |
233 |
$1K |
| V2104 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, 2.12 to 4.00d cylinder, per lens |
50 |
40 |
$1K |
| V2599 |
Contact lens, other type |
13 |
12 |
$1K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
418 |
362 |
$356.50 |
| V2107 |
Spherocylinder, single vision, plus or minus 4.25 to plus or minus 7.00 sphere, .12 to 2.00d cylinder, per lens |
15 |
13 |
$184.50 |
| V2025 |
Deluxe frame |
902 |
819 |
$-124.00 |