| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
1,869 |
1,726 |
$107K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
1,544 |
1,390 |
$45K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
765 |
700 |
$26K |
| 92015 |
Determination of refractive state |
2,688 |
2,479 |
$19K |
| V2020 |
Frames, purchases |
2,089 |
1,892 |
$16K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
2,131 |
1,904 |
$12K |
| V2203 |
Spherocylinder, bifocal, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
210 |
195 |
$11K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
281 |
244 |
$8K |
| 92341 |
|
371 |
336 |
$2K |
| V2104 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, 2.12 to 4.00d cylinder, per lens |
12 |
12 |
$120.50 |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
96 |
93 |
$72.50 |
| V2025 |
Deluxe frame |
740 |
674 |
$-202.00 |