| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
1,903 |
1,860 |
$137K |
| V2020 |
Frames, purchases |
2,353 |
2,296 |
$64K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
618 |
599 |
$54K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
2,122 |
2,063 |
$44K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
1,677 |
1,638 |
$40K |
| 92015 |
Determination of refractive state |
3,123 |
3,049 |
$35K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
2,352 |
2,289 |
$16K |
| V2715 |
Prism, per lens |
816 |
792 |
$6K |
| 92341 |
|
121 |
119 |
$3K |
| V2203 |
Spherocylinder, bifocal, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
40 |
39 |
$972.03 |