| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
2,522 |
2,210 |
$265K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
2,876 |
2,574 |
$259K |
| V2025 |
Deluxe frame |
649 |
591 |
$52K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
1,482 |
1,371 |
$37K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
641 |
590 |
$29K |
| V2750 |
Anti-reflective coating, per lens |
1,018 |
948 |
$25K |
| V2020 |
Frames, purchases |
742 |
676 |
$24K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
380 |
359 |
$6K |
| 92250 |
|
221 |
159 |
$5K |
| 92015 |
Determination of refractive state |
3,234 |
2,881 |
$2K |
| V2410 |
Variable asphericity lens, single vision, full field, glass or plastic, per lens |
12 |
12 |
$660.00 |
| V2799 |
Vision item or service, miscellaneous |
16 |
16 |
$0.00 |