| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
1,498 |
1,481 |
$68K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
993 |
987 |
$45K |
| V2020 |
Frames, purchases |
1,896 |
1,865 |
$33K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
1,863 |
1,842 |
$32K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
847 |
833 |
$21K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
1,127 |
1,110 |
$16K |
| 92015 |
Determination of refractive state |
231 |
214 |
$4K |
| V2200 |
Sphere, bifocal, plano to plus or minus 4.00d, per lens |
15 |
15 |
$836.50 |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
841 |
823 |
$829.50 |
| V2025 |
Deluxe frame |
384 |
380 |
$672.00 |
| V2107 |
Spherocylinder, single vision, plus or minus 4.25 to plus or minus 7.00 sphere, .12 to 2.00d cylinder, per lens |
14 |
14 |
$227.50 |
| V2750 |
Anti-reflective coating, per lens |
80 |
77 |
$0.00 |