| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
7,319 |
6,877 |
$855K |
| V2020 |
Frames, purchases |
14,153 |
12,791 |
$620K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
5,084 |
4,739 |
$480K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
6,433 |
5,878 |
$313K |
| 92015 |
Determination of refractive state |
13,352 |
12,470 |
$206K |
| V2203 |
Spherocylinder, bifocal, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
1,425 |
1,283 |
$98K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
2,029 |
1,814 |
$88K |
| V2755 |
U-v lens, per lens |
2,808 |
2,492 |
$73K |
| V2410 |
Variable asphericity lens, single vision, full field, glass or plastic, per lens |
322 |
288 |
$57K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
454 |
336 |
$20K |
| V2104 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, 2.12 to 4.00d cylinder, per lens |
320 |
295 |
$13K |
| V2200 |
Sphere, bifocal, plano to plus or minus 4.00d, per lens |
190 |
167 |
$10K |
| V2107 |
Spherocylinder, single vision, plus or minus 4.25 to plus or minus 7.00 sphere, .12 to 2.00d cylinder, per lens |
187 |
162 |
$9K |
| 92002 |
|
88 |
79 |
$3K |
| V2750 |
Anti-reflective coating, per lens |
38 |
37 |
$112.00 |