| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
4,767 |
4,737 |
$415K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
2,165 |
2,140 |
$72K |
| V2020 |
Frames, purchases |
2,877 |
2,852 |
$61K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
3,489 |
3,445 |
$60K |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
444 |
443 |
$32K |
| V2025 |
Deluxe frame |
769 |
767 |
$24K |
| 92015 |
Determination of refractive state |
4,574 |
4,539 |
$18K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
150 |
147 |
$13K |
| 92225 |
|
310 |
303 |
$7K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
555 |
555 |
$6K |
| V2200 |
Sphere, bifocal, plano to plus or minus 4.00d, per lens |
124 |
124 |
$6K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
274 |
274 |
$5K |
| V2104 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, 2.12 to 4.00d cylinder, per lens |
79 |
79 |
$879.36 |
| V2760 |
Scratch resistant coating, per lens |
43 |
40 |
$0.00 |