| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
1,163 |
1,148 |
$105K |
| V2020 |
Frames, purchases |
2,676 |
2,558 |
$82K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
1,177 |
1,172 |
$81K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
1,974 |
1,958 |
$58K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
1,858 |
1,769 |
$40K |
| V2755 |
U-v lens, per lens |
1,836 |
1,732 |
$25K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
2,058 |
1,956 |
$16K |
| 92341 |
|
234 |
231 |
$6K |
| 92370 |
|
156 |
155 |
$5K |
| V2760 |
Scratch resistant coating, per lens |
2,207 |
2,094 |
$4K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
201 |
191 |
$4K |
| V2203 |
Spherocylinder, bifocal, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
95 |
94 |
$3K |
| V2783 |
Lens, index greater than or equal to 1.66 plastic or greater than or equal to 1.80 glass, excludes polycarbonate, per lens |
35 |
31 |
$2K |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
40 |
40 |
$2K |