| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
1,457 |
1,362 |
$136K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
2,371 |
2,155 |
$135K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
1,459 |
1,369 |
$120K |
| 92015 |
Determination of refractive state |
3,335 |
3,064 |
$67K |
| V2020 |
Frames, purchases |
2,886 |
2,634 |
$24K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
1,289 |
1,191 |
$17K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
1,736 |
1,531 |
$8K |
| 92341 |
|
143 |
138 |
$7K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
646 |
566 |
$7K |
| V2025 |
Deluxe frame |
137 |
128 |
$6K |
| V2755 |
U-v lens, per lens |
1,048 |
978 |
$6K |
| V2203 |
Spherocylinder, bifocal, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
87 |
84 |
$2K |
| 92250 |
|
119 |
94 |
$1K |
| V2750 |
Anti-reflective coating, per lens |
316 |
296 |
$1K |
| V2104 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, 2.12 to 4.00d cylinder, per lens |
16 |
15 |
$195.75 |
| V2756 |
Eye glass case |
72 |
59 |
$20.78 |
| V2744 |
Tint, photochromatic, per lens |
15 |
14 |
$0.00 |
| V2702 |
Deluxe lens feature |
14 |
12 |
$0.00 |
| V2745 |
Addition to lens; tint, any color, solid, gradient or equal, excludes photochromatic, any lens material, per lens |
76 |
68 |
$0.00 |