| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
1,587 |
1,513 |
$65K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
1,233 |
1,169 |
$42K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
525 |
507 |
$35K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
1,872 |
1,768 |
$10K |
| 92015 |
Determination of refractive state |
2,320 |
2,236 |
$10K |
| V2020 |
Frames, purchases |
1,125 |
1,071 |
$7K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
192 |
179 |
$6K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
251 |
232 |
$5.00 |
| V2025 |
Deluxe frame |
812 |
771 |
$0.00 |
| V2750 |
Anti-reflective coating, per lens |
27 |
25 |
$0.00 |