| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
626 |
545 |
$25K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
550 |
491 |
$23K |
| V2020 |
Frames, purchases |
708 |
671 |
$22K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
244 |
217 |
$15K |
| 92015 |
Determination of refractive state |
1,002 |
956 |
$13K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
263 |
252 |
$5K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
344 |
327 |
$4K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
83 |
82 |
$2K |
| V2025 |
Deluxe frame |
172 |
150 |
$2K |