| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
1,219 |
1,189 |
$122K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
2,367 |
2,038 |
$85K |
| V2020 |
Frames, purchases |
2,383 |
2,076 |
$68K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
1,968 |
1,733 |
$47K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
1,011 |
896 |
$38K |
| 92015 |
Determination of refractive state |
2,661 |
2,569 |
$32K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
402 |
389 |
$32K |
| 92250 |
|
892 |
874 |
$21K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
15 |
14 |
$1K |
| 92341 |
|
13 |
12 |
$280.57 |