| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
1,851 |
1,812 |
$183K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
3,301 |
1,591 |
$109K |
| V2020 |
Frames, purchases |
2,091 |
2,014 |
$101K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
1,046 |
1,028 |
$75K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
2,041 |
1,081 |
$53K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
2,613 |
2,607 |
$17K |
| 92015 |
Determination of refractive state |
3,100 |
3,043 |
$15K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
95 |
63 |
$3K |
| V2780 |
Oversize lens, per lens |
152 |
73 |
$2K |
| 92341 |
|
78 |
78 |
$510.00 |