| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
2,512 |
2,346 |
$124K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
3,443 |
3,190 |
$121K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
3,546 |
3,021 |
$98K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
1,242 |
1,065 |
$35K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
5,162 |
4,707 |
$32K |
| 92015 |
Determination of refractive state |
5,336 |
4,922 |
$30K |
| V2020 |
Frames, purchases |
4,525 |
4,168 |
$28K |
| V2203 |
Spherocylinder, bifocal, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
342 |
263 |
$8K |
| V2599 |
Contact lens, other type |
68 |
54 |
$6K |
| V2104 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, 2.12 to 4.00d cylinder, per lens |
226 |
191 |
$4K |
| 92341 |
|
447 |
418 |
$2K |
| V2107 |
Spherocylinder, single vision, plus or minus 4.25 to plus or minus 7.00 sphere, .12 to 2.00d cylinder, per lens |
14 |
12 |
$627.50 |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
473 |
447 |
$444.00 |
| 92310 |
|
73 |
69 |
$0.00 |
| 92342 |
|
233 |
233 |
$0.00 |
| V2756 |
Eye glass case |
233 |
233 |
$0.00 |
| V2750 |
Anti-reflective coating, per lens |
32 |
26 |
$0.00 |
| 2021F |
|
105 |
105 |
$0.00 |
| V2025 |
Deluxe frame |
1,700 |
1,547 |
$-248.00 |