| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
1,259 |
1,191 |
$78K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
716 |
674 |
$61K |
| V2020 |
Frames, purchases |
1,191 |
1,137 |
$40K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
678 |
651 |
$20K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
485 |
457 |
$9K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
589 |
557 |
$4K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
91 |
87 |
$2K |
| 92015 |
Determination of refractive state |
71 |
69 |
$1K |
| V2760 |
Scratch resistant coating, per lens |
518 |
488 |
$1K |
| 92002 |
|
12 |
12 |
$620.04 |
| V2200 |
Sphere, bifocal, plano to plus or minus 4.00d, per lens |
12 |
12 |
$192.50 |