| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
1,800 |
1,790 |
$96K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
4,951 |
2,536 |
$72K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
1,437 |
1,430 |
$65K |
| V2020 |
Frames, purchases |
4,956 |
4,683 |
$55K |
| 92250 |
|
619 |
606 |
$27K |
| V2200 |
Sphere, bifocal, plano to plus or minus 4.00d, per lens |
901 |
483 |
$19K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
857 |
764 |
$11K |
| 92341 |
|
569 |
508 |
$10K |
| V2203 |
Spherocylinder, bifocal, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
307 |
274 |
$5K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
511 |
406 |
$4K |
| 92134 |
|
27 |
27 |
$210.14 |
| 2022F |
|
27 |
27 |
$0.00 |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
1,092 |
522 |
$0.00 |