| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
726 |
663 |
$44K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
1,250 |
1,154 |
$44K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
1,107 |
997 |
$36K |
| 92015 |
Determination of refractive state |
1,960 |
1,812 |
$13K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
1,775 |
1,597 |
$12K |
| V2020 |
Frames, purchases |
1,280 |
1,153 |
$11K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
344 |
310 |
$10K |
| V2104 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, 2.12 to 4.00d cylinder, per lens |
24 |
24 |
$574.50 |
| V2025 |
Deluxe frame |
613 |
553 |
$0.00 |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
99 |
89 |
$0.00 |