| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
2,182 |
2,096 |
$143K |
| V2020 |
Frames, purchases |
2,910 |
2,387 |
$60K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
1,534 |
1,501 |
$44K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
245 |
240 |
$22K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
1,621 |
1,128 |
$20K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
1,032 |
906 |
$5K |
| V2203 |
Spherocylinder, bifocal, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
163 |
109 |
$4K |
| V2755 |
U-v lens, per lens |
406 |
375 |
$3K |
| 92341 |
|
83 |
78 |
$2K |
| 92015 |
Determination of refractive state |
2,412 |
2,306 |
$1K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
88 |
74 |
$1K |
| V2200 |
Sphere, bifocal, plano to plus or minus 4.00d, per lens |
17 |
15 |
$280.00 |
| S9999 |
Sales tax |
28 |
26 |
$37.41 |
| V2760 |
Scratch resistant coating, per lens |
15 |
14 |
$0.00 |