| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
557 |
524 |
$25K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
682 |
613 |
$14K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
125 |
109 |
$9K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
901 |
818 |
$4K |
| V2020 |
Frames, purchases |
861 |
790 |
$4K |
| 92015 |
Determination of refractive state |
949 |
876 |
$4K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
16 |
15 |
$22.00 |
| V2025 |
Deluxe frame |
62 |
60 |
$0.00 |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
15 |
14 |
$0.00 |