| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
345 |
325 |
$26K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
290 |
270 |
$15K |
| V2020 |
Frames, purchases |
557 |
521 |
$12K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
499 |
465 |
$8K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
476 |
445 |
$7K |
| 92015 |
Determination of refractive state |
639 |
598 |
$5K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
379 |
335 |
$4.94 |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
157 |
138 |
$1.81 |
| V2104 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, 2.12 to 4.00d cylinder, per lens |
17 |
15 |
$0.15 |