| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
1,376 |
1,282 |
$62K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
1,078 |
975 |
$34K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
428 |
403 |
$29K |
| V2020 |
Frames, purchases |
1,252 |
1,165 |
$7K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
1,549 |
1,422 |
$4K |
| 92015 |
Determination of refractive state |
1,999 |
1,883 |
$4K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
150 |
136 |
$3K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
134 |
130 |
$0.00 |
| V2025 |
Deluxe frame |
241 |
222 |
$0.00 |
| V2750 |
Anti-reflective coating, per lens |
12 |
12 |
$0.00 |