| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
4,091 |
3,991 |
$361K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
4,571 |
4,438 |
$356K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
9,826 |
9,132 |
$331K |
| V2020 |
Frames, purchases |
9,857 |
9,156 |
$291K |
| 92015 |
Determination of refractive state |
10,050 |
9,770 |
$116K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
4,811 |
4,558 |
$91K |
| 92250 |
|
3,546 |
3,419 |
$85K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
3,809 |
3,504 |
$85K |
| 92370 |
|
4,203 |
3,989 |
$69K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
798 |
762 |
$37K |
| V2203 |
Spherocylinder, bifocal, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
252 |
209 |
$9K |
| 92341 |
|
157 |
153 |
$4K |
| V2107 |
Spherocylinder, single vision, plus or minus 4.25 to plus or minus 7.00 sphere, .12 to 2.00d cylinder, per lens |
12 |
12 |
$373.56 |
| V2104 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, 2.12 to 4.00d cylinder, per lens |
12 |
12 |
$344.28 |