| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
2,309 |
2,306 |
$109K |
| V2020 |
Frames, purchases |
6,322 |
6,278 |
$37K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
4,254 |
2,382 |
$15K |
| 92015 |
Determination of refractive state |
3,022 |
3,017 |
$11K |
| V2520 |
Contact lens, hydrophilic, spherical, per lens |
282 |
282 |
$9K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
4,440 |
2,472 |
$9K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
107 |
107 |
$5K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
764 |
450 |
$2K |
| V2203 |
Spherocylinder, bifocal, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
338 |
191 |
$1K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
25 |
25 |
$400.00 |
| 3072F |
|
52 |
52 |
$0.00 |
| V2599 |
Contact lens, other type |
35 |
35 |
$0.00 |
| V2104 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, 2.12 to 4.00d cylinder, per lens |
24 |
12 |
$0.00 |
| V2500 |
Contact lens, pmma, spherical, per lens |
113 |
113 |
$0.00 |
| V2107 |
Spherocylinder, single vision, plus or minus 4.25 to plus or minus 7.00 sphere, .12 to 2.00d cylinder, per lens |
54 |
27 |
$0.00 |