| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
1,788 |
1,752 |
$61K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
2,023 |
1,970 |
$39K |
| V2020 |
Frames, purchases |
2,545 |
2,478 |
$38K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
795 |
786 |
$26K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
1,453 |
1,415 |
$13K |
| V2200 |
Sphere, bifocal, plano to plus or minus 4.00d, per lens |
122 |
120 |
$2K |
| 92015 |
Determination of refractive state |
2,773 |
2,722 |
$340.00 |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
12 |
12 |
$261.24 |