| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
1,576 |
1,462 |
$56K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
1,017 |
944 |
$42K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
583 |
544 |
$35K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
479 |
439 |
$18K |
| 92015 |
Determination of refractive state |
2,202 |
2,047 |
$16K |
| V2020 |
Frames, purchases |
1,270 |
1,158 |
$16K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
1,625 |
1,505 |
$14K |
| V2104 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, 2.12 to 4.00d cylinder, per lens |
16 |
14 |
$973.50 |
| V2025 |
Deluxe frame |
611 |
558 |
$0.00 |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
116 |
111 |
$0.00 |