| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
905 |
862 |
$47K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
310 |
291 |
$24K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
669 |
635 |
$18K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
144 |
137 |
$3K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
1,151 |
1,089 |
$3K |
| V2020 |
Frames, purchases |
1,005 |
953 |
$2K |
| 92015 |
Determination of refractive state |
1,359 |
1,302 |
$443.68 |
| 92310 |
|
13 |
12 |
$100.00 |
| V2025 |
Deluxe frame |
205 |
191 |
$0.00 |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
144 |
140 |
$0.00 |