| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
5,044 |
4,985 |
$194K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
7,089 |
6,960 |
$155K |
| V2020 |
Frames, purchases |
8,692 |
8,539 |
$144K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
3,799 |
3,759 |
$143K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
5,443 |
5,335 |
$51K |
| V2200 |
Sphere, bifocal, plano to plus or minus 4.00d, per lens |
1,140 |
1,124 |
$38K |
| 92015 |
Determination of refractive state |
9,043 |
8,944 |
$5K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
39 |
39 |
$838.14 |
| V2744 |
Tint, photochromatic, per lens |
12 |
12 |
$0.00 |
| V2782 |
Lens, index 1.54 to 1.65 plastic or 1.60 to 1.79 glass, excludes polycarbonate, per lens |
25 |
25 |
$0.00 |