| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
3,049 |
2,886 |
$198K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
1,615 |
1,508 |
$139K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
3,372 |
3,200 |
$98K |
| V2020 |
Frames, purchases |
4,554 |
3,647 |
$83K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
2,849 |
2,592 |
$52K |
| 92015 |
Determination of refractive state |
4,283 |
4,009 |
$23K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
2,792 |
2,314 |
$16K |
| V2760 |
Scratch resistant coating, per lens |
1,783 |
1,743 |
$3K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
547 |
279 |
$3K |
| S0516 |
Safety eyeglass frames |
167 |
166 |
$3K |
| 92285 |
|
153 |
145 |
$2K |
| 92341 |
|
58 |
51 |
$2K |
| S0504 |
Single vision prescription lens (safety, athletic, or sunglass), per lens |
162 |
161 |
$1K |
| S9999 |
Sales tax |
281 |
280 |
$458.49 |
| V2203 |
Spherocylinder, bifocal, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
29 |
14 |
$300.94 |