| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
1,020 |
939 |
$39K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
246 |
231 |
$14K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
517 |
494 |
$13K |
| V2020 |
Frames, purchases |
797 |
715 |
$12K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
1,392 |
1,071 |
$5K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
380 |
291 |
$2K |
| V2025 |
Deluxe frame |
195 |
150 |
$239.80 |
| V2755 |
U-v lens, per lens |
496 |
382 |
$121.40 |
| 92015 |
Determination of refractive state |
734 |
719 |
$14.94 |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
95 |
86 |
$0.00 |
| 3072F |
|
74 |
59 |
$0.00 |
| V2760 |
Scratch resistant coating, per lens |
152 |
107 |
$0.00 |