| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
2,930 |
2,749 |
$242K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
2,314 |
2,260 |
$149K |
| V2020 |
Frames, purchases |
4,051 |
3,868 |
$99K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
3,192 |
3,119 |
$84K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
2,738 |
2,266 |
$42K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
2,101 |
2,041 |
$35K |
| 92015 |
Determination of refractive state |
5,232 |
4,992 |
$26K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
234 |
178 |
$9K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
677 |
603 |
$9K |
| 92341 |
|
298 |
278 |
$7K |
| V2203 |
Spherocylinder, bifocal, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
293 |
223 |
$6K |
| V2760 |
Scratch resistant coating, per lens |
1,803 |
1,760 |
$6K |
| V2104 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, 2.12 to 4.00d cylinder, per lens |
62 |
56 |
$616.60 |