| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
4,685 |
4,559 |
$545K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
1,218 |
1,175 |
$146K |
| V2020 |
Frames, purchases |
3,744 |
3,641 |
$96K |
| 92015 |
Determination of refractive state |
6,213 |
6,002 |
$39K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
3,000 |
2,952 |
$9K |
| 92002 |
|
111 |
104 |
$7K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
196 |
171 |
$7K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
3,695 |
2,087 |
$6K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
212 |
174 |
$5K |
| V2104 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, 2.12 to 4.00d cylinder, per lens |
955 |
645 |
$2K |
| V2760 |
Scratch resistant coating, per lens |
77 |
67 |
$1K |
| V2105 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, 4.25 to 6.00d cylinder, per lens |
18 |
13 |
$0.00 |