| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
1,496 |
1,444 |
$99K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
1,263 |
1,195 |
$90K |
| V2020 |
Frames, purchases |
3,697 |
3,267 |
$25K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
3,473 |
3,123 |
$21K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
2,511 |
2,285 |
$12K |
| 92015 |
Determination of refractive state |
3,023 |
2,886 |
$8K |
| 2020F |
|
848 |
800 |
$180.35 |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
245 |
233 |
$112.50 |
| 92341 |
|
12 |
12 |
$105.00 |
| 1159F |
|
84 |
84 |
$0.00 |
| V2025 |
Deluxe frame |
237 |
221 |
$0.00 |
| 1160F |
|
84 |
84 |
$0.00 |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
618 |
496 |
$0.00 |
| V2104 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, 2.12 to 4.00d cylinder, per lens |
39 |
39 |
$0.00 |