| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
1,700 |
1,459 |
$128K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
1,258 |
1,136 |
$77K |
| V2020 |
Frames, purchases |
2,551 |
2,194 |
$64K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
1,889 |
1,783 |
$48K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
1,695 |
1,489 |
$28K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
1,441 |
1,286 |
$13K |
| 92341 |
|
82 |
74 |
$1K |
| V2203 |
Spherocylinder, bifocal, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
41 |
36 |
$903.70 |
| 92015 |
Determination of refractive state |
551 |
347 |
$836.82 |
| V2104 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, 2.12 to 4.00d cylinder, per lens |
14 |
13 |
$140.00 |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
12 |
12 |
$119.20 |
| V2780 |
Oversize lens, per lens |
83 |
32 |
$18.75 |