| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
839 |
802 |
$32K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
651 |
624 |
$24K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
172 |
162 |
$14K |
| 92015 |
Determination of refractive state |
1,292 |
1,234 |
$4K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
114 |
106 |
$4K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
1,155 |
1,097 |
$4K |
| V2020 |
Frames, purchases |
759 |
723 |
$1K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
27 |
27 |
$0.00 |
| V2025 |
Deluxe frame |
146 |
141 |
$0.00 |