| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
3,190 |
2,961 |
$124K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
2,226 |
2,079 |
$88K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
823 |
793 |
$55K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
1,004 |
923 |
$37K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
3,657 |
3,400 |
$21K |
| V2020 |
Frames, purchases |
2,937 |
2,740 |
$19K |
| 92015 |
Determination of refractive state |
4,066 |
3,818 |
$16K |
| V2203 |
Spherocylinder, bifocal, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
25 |
24 |
$2K |
| V2104 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, 2.12 to 4.00d cylinder, per lens |
42 |
41 |
$1K |
| V2107 |
Spherocylinder, single vision, plus or minus 4.25 to plus or minus 7.00 sphere, .12 to 2.00d cylinder, per lens |
14 |
13 |
$455.00 |
| 92341 |
|
42 |
39 |
$14.50 |
| 92310 |
|
38 |
37 |
$0.00 |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
420 |
397 |
$0.00 |
| V2750 |
Anti-reflective coating, per lens |
241 |
222 |
$0.00 |
| V2025 |
Deluxe frame |
1,237 |
1,142 |
$-551.00 |