| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
1,219 |
1,174 |
$81K |
| V2020 |
Frames, purchases |
1,548 |
1,494 |
$46K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
510 |
484 |
$44K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
1,304 |
1,277 |
$38K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
808 |
775 |
$14K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
931 |
900 |
$7K |
| 92015 |
Determination of refractive state |
1,293 |
1,234 |
$5K |
| V2760 |
Scratch resistant coating, per lens |
867 |
847 |
$2K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
85 |
84 |
$1K |
| 92341 |
|
25 |
24 |
$312.00 |