| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
1,930 |
1,918 |
$160K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
1,727 |
1,719 |
$136K |
| V2020 |
Frames, purchases |
3,946 |
3,924 |
$110K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
1,708 |
1,699 |
$58K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
1,293 |
1,290 |
$42K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
1,001 |
996 |
$18K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
1,358 |
1,355 |
$10K |
| 92015 |
Determination of refractive state |
1,761 |
1,752 |
$9K |
| V2104 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, 2.12 to 4.00d cylinder, per lens |
143 |
143 |
$3K |
| V2025 |
Deluxe frame |
73 |
72 |
$2K |
| V2744 |
Tint, photochromatic, per lens |
80 |
80 |
$80.00 |