| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92250 |
|
2,126 |
2,124 |
$98K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
1,399 |
1,395 |
$83K |
| 92285 |
|
2,210 |
2,207 |
$63K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
899 |
896 |
$61K |
| V2020 |
Frames, purchases |
2,139 |
2,133 |
$27K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
1,375 |
702 |
$19K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
546 |
284 |
$4K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
2,427 |
1,235 |
$2K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
12 |
12 |
$175.50 |
| V2755 |
U-v lens, per lens |
404 |
201 |
$0.00 |