| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
1,934 |
1,893 |
$125K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
1,784 |
1,747 |
$117K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
4,919 |
4,891 |
$76K |
| V2020 |
Frames, purchases |
5,165 |
5,125 |
$47K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
1,192 |
1,171 |
$24K |
| 92015 |
Determination of refractive state |
1,475 |
1,454 |
$22K |
| V2025 |
Deluxe frame |
265 |
265 |
$12K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
3,254 |
3,235 |
$11K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
1,534 |
1,524 |
$2K |
| V2200 |
Sphere, bifocal, plano to plus or minus 4.00d, per lens |
12 |
12 |
$352.75 |
| V2104 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, 2.12 to 4.00d cylinder, per lens |
115 |
115 |
$60.00 |
| V2107 |
Spherocylinder, single vision, plus or minus 4.25 to plus or minus 7.00 sphere, .12 to 2.00d cylinder, per lens |
12 |
12 |
$0.00 |