| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
2,686 |
2,529 |
$119K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
1,213 |
1,160 |
$89K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
1,974 |
1,846 |
$71K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
831 |
770 |
$26K |
| 92015 |
Determination of refractive state |
3,995 |
3,788 |
$15K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
3,037 |
2,830 |
$14K |
| V2020 |
Frames, purchases |
2,219 |
2,096 |
$14K |
| V2104 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, 2.12 to 4.00d cylinder, per lens |
12 |
12 |
$392.50 |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
421 |
400 |
$141.00 |
| 92310 |
|
12 |
12 |
$0.00 |
| V2025 |
Deluxe frame |
1,135 |
1,055 |
$0.00 |
| V2750 |
Anti-reflective coating, per lens |
170 |
151 |
$0.00 |