| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
9,364 |
8,672 |
$388K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
6,931 |
6,654 |
$297K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
12,283 |
12,167 |
$189K |
| V2020 |
Frames, purchases |
12,710 |
12,514 |
$108K |
| V2782 |
Lens, index 1.54 to 1.65 plastic or 1.60 to 1.79 glass, excludes polycarbonate, per lens |
1,959 |
1,914 |
$99K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
3,490 |
3,408 |
$56K |
| 92015 |
Determination of refractive state |
2,694 |
2,561 |
$39K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
6,104 |
6,047 |
$21K |
| V2200 |
Sphere, bifocal, plano to plus or minus 4.00d, per lens |
267 |
264 |
$10K |
| V2203 |
Spherocylinder, bifocal, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
946 |
933 |
$7K |
| V2104 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, 2.12 to 4.00d cylinder, per lens |
1,534 |
1,522 |
$3K |
| V2107 |
Spherocylinder, single vision, plus or minus 4.25 to plus or minus 7.00 sphere, .12 to 2.00d cylinder, per lens |
394 |
390 |
$1K |
| 92250 |
|
12 |
12 |
$309.89 |
| V2105 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, 4.25 to 6.00d cylinder, per lens |
26 |
26 |
$100.00 |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
4,689 |
4,646 |
$35.00 |
| V2025 |
Deluxe frame |
106 |
106 |
$0.00 |