| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
2,005 |
1,577 |
$149K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
1,199 |
980 |
$90K |
| V2020 |
Frames, purchases |
3,355 |
2,598 |
$51K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
2,745 |
1,309 |
$13K |
| 92015 |
Determination of refractive state |
3,555 |
2,854 |
$12K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
2,566 |
2,011 |
$8K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
2,239 |
1,671 |
$5K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
1,192 |
639 |
$4K |
| 92341 |
|
28 |
28 |
$675.00 |
| V2203 |
Spherocylinder, bifocal, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
17 |
12 |
$270.00 |
| V2107 |
Spherocylinder, single vision, plus or minus 4.25 to plus or minus 7.00 sphere, .12 to 2.00d cylinder, per lens |
19 |
12 |
$0.00 |