| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
884 |
874 |
$33K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
817 |
808 |
$30K |
| V2020 |
Frames, purchases |
1,899 |
1,873 |
$27K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
978 |
961 |
$16K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
634 |
622 |
$11K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
347 |
343 |
$6K |
| 92015 |
Determination of refractive state |
1,674 |
1,657 |
$2K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
519 |
515 |
$2K |
| V2200 |
Sphere, bifocal, plano to plus or minus 4.00d, per lens |
66 |
66 |
$2K |
| V2203 |
Spherocylinder, bifocal, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
44 |
44 |
$1K |
| V2760 |
Scratch resistant coating, per lens |
79 |
78 |
$730.00 |
| V2755 |
U-v lens, per lens |
77 |
76 |
$432.00 |