| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
961 |
954 |
$88K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
878 |
870 |
$60K |
| V2020 |
Frames, purchases |
1,597 |
1,426 |
$46K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
1,092 |
1,080 |
$31K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
1,047 |
921 |
$19K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
1,404 |
1,218 |
$8K |
| 92015 |
Determination of refractive state |
1,188 |
1,180 |
$3K |
| V2760 |
Scratch resistant coating, per lens |
595 |
575 |
$1K |
| 92370 |
|
18 |
17 |
$493.00 |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
30 |
24 |
$284.00 |