| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
2,702 |
2,623 |
$184K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
736 |
727 |
$56K |
| V2020 |
Frames, purchases |
1,106 |
1,045 |
$53K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
972 |
453 |
$24K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
669 |
364 |
$19K |
| 92015 |
Determination of refractive state |
3,764 |
3,664 |
$19K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
1,656 |
1,641 |
$11K |
| 92250 |
|
170 |
163 |
$4K |
| 92002 |
|
13 |
13 |
$404.04 |