| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
4,097 |
4,002 |
$271K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
1,768 |
1,721 |
$158K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
4,797 |
4,683 |
$141K |
| V2020 |
Frames, purchases |
6,030 |
5,328 |
$131K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
3,884 |
3,750 |
$86K |
| 92015 |
Determination of refractive state |
2,267 |
2,247 |
$45K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
4,400 |
3,777 |
$31K |
| 92370 |
|
184 |
175 |
$5K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
781 |
489 |
$3K |
| V2760 |
Scratch resistant coating, per lens |
563 |
549 |
$2K |
| V2200 |
Sphere, bifocal, plano to plus or minus 4.00d, per lens |
62 |
60 |
$1K |
| S0516 |
Safety eyeglass frames |
14 |
14 |
$223.72 |
| S0504 |
Single vision prescription lens (safety, athletic, or sunglass), per lens |
14 |
14 |
$129.86 |
| S9999 |
Sales tax |
39 |
38 |
$78.96 |