| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
445 |
438 |
$19K |
| V2025 |
Deluxe frame |
250 |
250 |
$12K |
| V2020 |
Frames, purchases |
244 |
229 |
$7K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
336 |
323 |
$5K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
164 |
161 |
$5K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
112 |
109 |
$4K |
| 92015 |
Determination of refractive state |
385 |
374 |
$1K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
251 |
198 |
$646.75 |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
173 |
165 |
$73.50 |