| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
2,823 |
2,771 |
$182K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
583 |
556 |
$48K |
| V2020 |
Frames, purchases |
1,084 |
971 |
$28K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
923 |
869 |
$21K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
696 |
612 |
$15K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
973 |
854 |
$6K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
121 |
113 |
$3K |
| V2760 |
Scratch resistant coating, per lens |
513 |
467 |
$899.00 |
| V2203 |
Spherocylinder, bifocal, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
15 |
13 |
$622.11 |
| 92015 |
Determination of refractive state |
118 |
118 |
$323.52 |
| V2104 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, 2.12 to 4.00d cylinder, per lens |
12 |
12 |
$292.00 |
| 92310 |
|
27 |
25 |
$59.00 |