| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
1,126 |
1,063 |
$72K |
| V2020 |
Frames, purchases |
1,592 |
1,472 |
$47K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
516 |
501 |
$46K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
1,114 |
1,088 |
$31K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
668 |
618 |
$11K |
| 92015 |
Determination of refractive state |
1,389 |
1,316 |
$6K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
520 |
497 |
$4K |
| V2760 |
Scratch resistant coating, per lens |
413 |
405 |
$764.17 |
| 92341 |
|
25 |
25 |
$360.00 |
| V2203 |
Spherocylinder, bifocal, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
15 |
13 |
$357.49 |
| V2104 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, 2.12 to 4.00d cylinder, per lens |
16 |
15 |
$190.56 |