| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
2,045 |
1,931 |
$94K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
1,028 |
946 |
$71K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
2,046 |
1,898 |
$63K |
| V2020 |
Frames, purchases |
2,372 |
2,208 |
$15K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
2,742 |
2,539 |
$11K |
| 92015 |
Determination of refractive state |
3,085 |
2,903 |
$8K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
246 |
222 |
$5K |
| V2104 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, 2.12 to 4.00d cylinder, per lens |
95 |
84 |
$2K |
| V2203 |
Spherocylinder, bifocal, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
41 |
41 |
$2K |
| 92341 |
|
24 |
24 |
$0.00 |
| V2025 |
Deluxe frame |
580 |
532 |
$0.00 |
| V2750 |
Anti-reflective coating, per lens |
120 |
115 |
$0.00 |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
421 |
401 |
$0.00 |