| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
1,017 |
960 |
$36K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
775 |
725 |
$32K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
238 |
221 |
$15K |
| V2020 |
Frames, purchases |
1,194 |
1,111 |
$9K |
| 92015 |
Determination of refractive state |
1,664 |
1,571 |
$6K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
1,224 |
1,136 |
$6K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
42 |
41 |
$850.00 |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
108 |
105 |
$5.00 |
| V2025 |
Deluxe frame |
176 |
171 |
$0.00 |