| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
5,614 |
5,510 |
$339K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
3,321 |
3,278 |
$207K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
4,902 |
4,866 |
$154K |
| V2020 |
Frames, purchases |
7,790 |
7,630 |
$146K |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
1,267 |
1,267 |
$92K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
5,667 |
5,552 |
$80K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
2,459 |
2,356 |
$36K |
| V2025 |
Deluxe frame |
1,172 |
1,167 |
$28K |
| 92370 |
|
1,036 |
994 |
$20K |
| 92015 |
Determination of refractive state |
8,259 |
8,110 |
$18K |
| V2200 |
Sphere, bifocal, plano to plus or minus 4.00d, per lens |
362 |
362 |
$16K |
| V2104 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, 2.12 to 4.00d cylinder, per lens |
534 |
510 |
$6K |
| V2203 |
Spherocylinder, bifocal, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
78 |
78 |
$1K |
| 92341 |
|
25 |
25 |
$1K |
| V2107 |
Spherocylinder, single vision, plus or minus 4.25 to plus or minus 7.00 sphere, .12 to 2.00d cylinder, per lens |
96 |
84 |
$753.92 |
| V2105 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, 4.25 to 6.00d cylinder, per lens |
52 |
52 |
$671.37 |
| V2782 |
Lens, index 1.54 to 1.65 plastic or 1.60 to 1.79 glass, excludes polycarbonate, per lens |
152 |
152 |
$0.00 |