| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
1,847 |
1,812 |
$56K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
2,307 |
1,446 |
$40K |
| V2020 |
Frames, purchases |
2,747 |
2,708 |
$39K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
1,076 |
1,060 |
$30K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
378 |
260 |
$4K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
1,732 |
1,037 |
$3K |
| V2200 |
Sphere, bifocal, plano to plus or minus 4.00d, per lens |
106 |
72 |
$3K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
183 |
183 |
$375.00 |
| 92015 |
Determination of refractive state |
2,379 |
2,352 |
$0.00 |