| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
1,285 |
1,212 |
$92K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
772 |
692 |
$39K |
| V2020 |
Frames, purchases |
675 |
631 |
$19K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
479 |
448 |
$12K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
386 |
362 |
$8K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
282 |
262 |
$2K |
| 92015 |
Determination of refractive state |
1,006 |
952 |
$869.43 |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
33 |
28 |
$407.54 |
| V2760 |
Scratch resistant coating, per lens |
214 |
199 |
$389.95 |
| 92341 |
|
27 |
24 |
$100.25 |