| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
2,492 |
2,279 |
$91K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
1,876 |
1,579 |
$43K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
845 |
787 |
$41K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
804 |
676 |
$16K |
| V2020 |
Frames, purchases |
2,679 |
2,486 |
$12K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
2,907 |
2,673 |
$6K |
| 92015 |
Determination of refractive state |
3,015 |
2,745 |
$5K |
| 92341 |
|
26 |
26 |
$39.50 |
| V2756 |
Eye glass case |
246 |
246 |
$0.00 |
| 92342 |
|
246 |
246 |
$0.00 |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
84 |
77 |
$0.00 |
| V2025 |
Deluxe frame |
505 |
461 |
$0.00 |
| 2021F |
|
128 |
128 |
$0.00 |