| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
1,018 |
979 |
$74K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
1,483 |
1,395 |
$59K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
1,480 |
1,380 |
$49K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
2,232 |
2,069 |
$13K |
| V2020 |
Frames, purchases |
1,833 |
1,714 |
$13K |
| 92015 |
Determination of refractive state |
2,572 |
2,449 |
$11K |
| V2104 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, 2.12 to 4.00d cylinder, per lens |
119 |
106 |
$3K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
103 |
99 |
$2K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
220 |
200 |
$15.00 |
| 92341 |
|
12 |
12 |
$14.50 |
| V2025 |
Deluxe frame |
528 |
490 |
$0.00 |
| V2750 |
Anti-reflective coating, per lens |
93 |
84 |
$0.00 |