| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
624 |
590 |
$29K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
1,024 |
518 |
$21K |
| V2020 |
Frames, purchases |
1,137 |
1,117 |
$21K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
338 |
332 |
$20K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
221 |
221 |
$4K |
| 92015 |
Determination of refractive state |
1,189 |
1,102 |
$3K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
104 |
68 |
$3K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
1,767 |
894 |
$1K |