| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
1,363 |
1,301 |
$84K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
521 |
501 |
$44K |
| V2020 |
Frames, purchases |
1,421 |
1,316 |
$29K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
1,099 |
1,035 |
$28K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
613 |
572 |
$12K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
1,091 |
1,028 |
$10K |
| 92015 |
Determination of refractive state |
1,867 |
1,775 |
$10K |
| 92250 |
|
51 |
48 |
$1K |
| V2755 |
U-v lens, per lens |
47 |
42 |
$845.88 |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
45 |
43 |
$675.00 |
| V2101 |
Sphere, single vision, plus or minus 4.12 to plus or minus 7.00d, per lens |
12 |
12 |
$110.40 |
| 2023F |
|
62 |
62 |
$0.00 |