| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
2,149 |
2,048 |
$82K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
1,153 |
1,108 |
$66K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
1,821 |
1,636 |
$50K |
| V2020 |
Frames, purchases |
2,286 |
2,161 |
$17K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
2,594 |
2,443 |
$16K |
| 92015 |
Determination of refractive state |
3,044 |
2,907 |
$15K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
671 |
597 |
$14K |
| V2025 |
Deluxe frame |
703 |
662 |
$0.00 |
| 2021F |
|
80 |
80 |
$0.00 |
| 92341 |
|
25 |
25 |
$0.00 |
| V2750 |
Anti-reflective coating, per lens |
13 |
13 |
$0.00 |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
267 |
261 |
$0.00 |
| V2756 |
Eye glass case |
132 |
132 |
$0.00 |
| 92310 |
|
13 |
12 |
$0.00 |
| 92342 |
|
132 |
132 |
$0.00 |