| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
1,526 |
1,490 |
$137K |
| V2020 |
Frames, purchases |
1,514 |
1,484 |
$45K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
523 |
518 |
$36K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
985 |
965 |
$23K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
1,157 |
1,133 |
$23K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
724 |
707 |
$7K |
| 92015 |
Determination of refractive state |
1,984 |
1,933 |
$7K |
| V2760 |
Scratch resistant coating, per lens |
761 |
736 |
$2K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
127 |
125 |
$1K |
| 92341 |
|
12 |
12 |
$165.00 |
| 3072F |
|
573 |
560 |
$0.00 |
| 2033F |
|
35 |
35 |
$0.00 |