| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
2,534 |
2,255 |
$90K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
2,190 |
1,839 |
$55K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
813 |
734 |
$43K |
| V2020 |
Frames, purchases |
2,295 |
2,044 |
$15K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
2,785 |
2,445 |
$11K |
| 92015 |
Determination of refractive state |
3,079 |
2,725 |
$10K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
463 |
382 |
$6K |
| 92310 |
|
49 |
41 |
$159.95 |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
143 |
132 |
$5.00 |
| V2756 |
Eye glass case |
131 |
130 |
$0.00 |
| 92342 |
|
131 |
130 |
$0.00 |
| 2021F |
|
108 |
108 |
$0.00 |
| 92341 |
|
17 |
13 |
$0.00 |
| V2025 |
Deluxe frame |
847 |
731 |
$-74.50 |