| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
3,063 |
2,788 |
$335K |
| V2410 |
Variable asphericity lens, single vision, full field, glass or plastic, per lens |
1,817 |
1,528 |
$250K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
1,236 |
1,137 |
$120K |
| V2020 |
Frames, purchases |
2,058 |
1,717 |
$91K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
2,113 |
1,757 |
$73K |
| V2755 |
U-v lens, per lens |
2,109 |
1,757 |
$57K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
1,217 |
1,030 |
$55K |
| V2750 |
Anti-reflective coating, per lens |
2,098 |
1,747 |
$51K |
| V2430 |
Variable asphericity lens, bifocal, full field, glass or plastic, per lens |
94 |
69 |
$16K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
1,816 |
1,528 |
$13K |
| 92015 |
Determination of refractive state |
4,400 |
3,966 |
$11K |
| V2104 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, 2.12 to 4.00d cylinder, per lens |
68 |
56 |
$3K |
| 92341 |
|
91 |
66 |
$2K |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
13 |
12 |
$951.45 |
| V2203 |
Spherocylinder, bifocal, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
14 |
13 |
$852.04 |
| 92250 |
|
14 |
14 |
$503.23 |