| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
4,726 |
4,622 |
$379K |
| V2020 |
Frames, purchases |
6,256 |
6,109 |
$210K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
2,931 |
2,873 |
$192K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
4,662 |
3,297 |
$141K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
4,438 |
2,594 |
$56K |
| 92015 |
Determination of refractive state |
8,019 |
7,823 |
$37K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
2,872 |
1,920 |
$34K |
| V2203 |
Spherocylinder, bifocal, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
168 |
92 |
$4K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
501 |
488 |
$3K |
| V2104 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, 2.12 to 4.00d cylinder, per lens |
174 |
108 |
$2K |
| 92370 |
|
237 |
235 |
$1K |
| V2200 |
Sphere, bifocal, plano to plus or minus 4.00d, per lens |
44 |
25 |
$1K |
| 92002 |
|
18 |
18 |
$569.36 |