| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
2,887 |
2,630 |
$98K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
2,173 |
1,893 |
$77K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
1,076 |
978 |
$61K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
966 |
848 |
$27K |
| V2020 |
Frames, purchases |
2,403 |
2,103 |
$25K |
| 92015 |
Determination of refractive state |
3,631 |
3,303 |
$22K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
3,183 |
2,777 |
$20K |
| V2599 |
Contact lens, other type |
35 |
33 |
$6K |
| V2104 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, 2.12 to 4.00d cylinder, per lens |
204 |
190 |
$4K |
| V2203 |
Spherocylinder, bifocal, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
28 |
26 |
$2K |
| 92310 |
|
100 |
90 |
$580.00 |
| V2107 |
Spherocylinder, single vision, plus or minus 4.25 to plus or minus 7.00 sphere, .12 to 2.00d cylinder, per lens |
17 |
12 |
$288.00 |
| 92341 |
|
68 |
64 |
$284.66 |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
261 |
238 |
$0.00 |
| V2750 |
Anti-reflective coating, per lens |
87 |
80 |
$0.00 |
| V2025 |
Deluxe frame |
1,275 |
1,146 |
$-130.00 |