| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
1,152 |
1,093 |
$101K |
| V2020 |
Frames, purchases |
2,011 |
1,307 |
$24K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
771 |
508 |
$12K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
82 |
73 |
$7K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
1,904 |
1,258 |
$5K |
| 92015 |
Determination of refractive state |
1,369 |
1,295 |
$2K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
860 |
554 |
$2K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
1,706 |
1,041 |
$194.38 |
| 92310 |
|
28 |
28 |
$85.00 |