| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
1,139 |
1,132 |
$178K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
1,042 |
1,038 |
$143K |
| V2020 |
Frames, purchases |
2,307 |
2,304 |
$135K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
1,958 |
1,955 |
$56K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
1,072 |
1,062 |
$44K |
| V2025 |
Deluxe frame |
396 |
395 |
$30K |
| 92015 |
Determination of refractive state |
1,882 |
1,867 |
$12K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
1,475 |
1,461 |
$11K |
| V2104 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, 2.12 to 4.00d cylinder, per lens |
154 |
154 |
$9K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
157 |
157 |
$7K |