| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
3,582 |
3,447 |
$264K |
| V2020 |
Frames, purchases |
6,786 |
6,473 |
$228K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
8,101 |
3,948 |
$203K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
3,047 |
2,937 |
$188K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
5,853 |
3,278 |
$111K |
| V2203 |
Spherocylinder, bifocal, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
2,088 |
1,119 |
$61K |
| V2104 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, 2.12 to 4.00d cylinder, per lens |
1,338 |
906 |
$38K |
| 92015 |
Determination of refractive state |
6,026 |
5,849 |
$28K |
| V2780 |
Oversize lens, per lens |
465 |
222 |
$5K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
133 |
99 |
$2K |
| V2303 |
Spherocylinder, trifocal, plano to plus or minus 4.00d sphere, .12-2.00d cylinder, per lens |
28 |
14 |
$1K |
| V2107 |
Spherocylinder, single vision, plus or minus 4.25 to plus or minus 7.00 sphere, .12 to 2.00d cylinder, per lens |
31 |
24 |
$973.95 |
| V2781 |
Progressive lens, per lens |
30 |
13 |
$853.36 |
| 92370 |
|
16 |
16 |
$231.90 |