| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
2,309 |
2,172 |
$83K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
967 |
910 |
$63K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
1,096 |
1,019 |
$49K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
918 |
842 |
$41K |
| 92015 |
Determination of refractive state |
3,156 |
2,975 |
$13K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
2,412 |
2,234 |
$10K |
| V2020 |
Frames, purchases |
1,831 |
1,696 |
$9K |
| V2599 |
Contact lens, other type |
14 |
12 |
$2K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
240 |
233 |
$0.00 |
| 92310 |
|
12 |
12 |
$0.00 |
| V2025 |
Deluxe frame |
887 |
815 |
$-116.00 |