| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
579 |
525 |
$104K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
476 |
442 |
$73K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
995 |
645 |
$55K |
| V2783 |
Lens, index greater than or equal to 1.66 plastic or greater than or equal to 1.80 glass, excludes polycarbonate, per lens |
1,239 |
814 |
$54K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
1,438 |
918 |
$25K |
| V2020 |
Frames, purchases |
1,605 |
1,061 |
$19K |
| 92015 |
Determination of refractive state |
1,199 |
1,103 |
$13K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
64 |
41 |
$2K |
| 92341 |
|
15 |
14 |
$910.00 |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
19 |
12 |
$0.00 |