| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
1,615 |
1,493 |
$79K |
| V2020 |
Frames, purchases |
3,196 |
3,165 |
$70K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
3,045 |
1,555 |
$64K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
1,294 |
1,186 |
$61K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
769 |
502 |
$22K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
692 |
692 |
$9K |
| 92015 |
Determination of refractive state |
2,548 |
2,253 |
$6K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
4,632 |
2,374 |
$4K |