| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
1,056 |
996 |
$98K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
724 |
685 |
$82K |
| V2020 |
Frames, purchases |
1,957 |
1,769 |
$61K |
| 92015 |
Determination of refractive state |
2,110 |
1,950 |
$33K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
857 |
830 |
$23K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
1,848 |
1,671 |
$19K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
452 |
392 |
$13K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
818 |
740 |
$7K |
| V2104 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, 2.12 to 4.00d cylinder, per lens |
14 |
14 |
$396.51 |