| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
797 |
730 |
$50K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
1,309 |
1,199 |
$49K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
1,153 |
1,068 |
$41K |
| V2020 |
Frames, purchases |
1,378 |
1,252 |
$9K |
| 92015 |
Determination of refractive state |
1,887 |
1,736 |
$7K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
1,689 |
1,540 |
$7K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
42 |
38 |
$1K |
| V2025 |
Deluxe frame |
416 |
386 |
$0.00 |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
85 |
83 |
$0.00 |