| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
1,520 |
1,505 |
$94K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
685 |
670 |
$65K |
| V2020 |
Frames, purchases |
570 |
538 |
$27K |
| 92015 |
Determination of refractive state |
2,390 |
2,355 |
$11K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
1,453 |
1,438 |
$9K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
100 |
89 |
$4K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
89 |
42 |
$3K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
207 |
113 |
$3K |
| V2744 |
Tint, photochromatic, per lens |
18 |
13 |
$263.70 |