| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
11,522 |
11,276 |
$963K |
| V2020 |
Frames, purchases |
25,774 |
25,218 |
$805K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
12,849 |
12,577 |
$798K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
20,550 |
19,500 |
$534K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
17,831 |
16,660 |
$274K |
| 92015 |
Determination of refractive state |
27,081 |
26,404 |
$118K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
3,972 |
3,840 |
$51K |
| V2203 |
Spherocylinder, bifocal, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
1,389 |
972 |
$37K |
| V2104 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, 2.12 to 4.00d cylinder, per lens |
2,293 |
2,182 |
$31K |
| V2744 |
Tint, photochromatic, per lens |
1,369 |
1,013 |
$24K |
| V2107 |
Spherocylinder, single vision, plus or minus 4.25 to plus or minus 7.00 sphere, .12 to 2.00d cylinder, per lens |
619 |
556 |
$9K |
| V2105 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, 4.25 to 6.00d cylinder, per lens |
14 |
13 |
$433.04 |
| 92002 |
|
13 |
13 |
$345.40 |