| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
563 |
552 |
$29K |
| V2020 |
Frames, purchases |
1,067 |
995 |
$24K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
331 |
326 |
$12K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
954 |
889 |
$4K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
719 |
647 |
$2K |
| 92015 |
Determination of refractive state |
1,239 |
1,217 |
$2K |
| 3072F |
|
160 |
160 |
$0.00 |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
178 |
87 |
$0.00 |
| V2756 |
Eye glass case |
313 |
309 |
$0.00 |
| 92342 |
|
313 |
309 |
$0.00 |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
86 |
82 |
$0.00 |
| 2022F |
|
282 |
282 |
$0.00 |
| V2025 |
Deluxe frame |
14 |
14 |
$0.00 |
| V2750 |
Anti-reflective coating, per lens |
29 |
27 |
$0.00 |