| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
1,191 |
1,150 |
$90K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
1,327 |
1,283 |
$88K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
1,511 |
1,381 |
$28K |
| V2020 |
Frames, purchases |
1,991 |
1,845 |
$20K |
| 92015 |
Determination of refractive state |
2,559 |
2,459 |
$4K |
| V2599 |
Contact lens, other type |
19 |
17 |
$3K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
256 |
247 |
$3K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
1,930 |
1,857 |
$1K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
502 |
416 |
$110.00 |
| 92310 |
|
31 |
30 |
$95.00 |
| V2760 |
Scratch resistant coating, per lens |
50 |
27 |
$0.00 |