| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
1,160 |
1,068 |
$72K |
| V2020 |
Frames, purchases |
1,505 |
1,260 |
$36K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
921 |
627 |
$11K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
297 |
250 |
$7K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
389 |
321 |
$2K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
32 |
24 |
$2K |
| 92370 |
|
24 |
24 |
$696.00 |
| 92015 |
Determination of refractive state |
1,177 |
1,068 |
$677.34 |
| V2755 |
U-v lens, per lens |
223 |
175 |
$641.67 |