| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
2,210 |
2,168 |
$97K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
2,076 |
2,018 |
$90K |
| V2020 |
Frames, purchases |
3,190 |
3,073 |
$82K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
1,724 |
1,638 |
$48K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
1,564 |
1,541 |
$27K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
794 |
781 |
$11K |
| 92015 |
Determination of refractive state |
279 |
273 |
$5K |
| V2025 |
Deluxe frame |
138 |
137 |
$2K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
675 |
661 |
$1K |
| V2104 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, 2.12 to 4.00d cylinder, per lens |
46 |
42 |
$477.50 |
| V2107 |
Spherocylinder, single vision, plus or minus 4.25 to plus or minus 7.00 sphere, .12 to 2.00d cylinder, per lens |
13 |
12 |
$115.00 |
| V2750 |
Anti-reflective coating, per lens |
13 |
13 |
$0.00 |