| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
2,221 |
2,183 |
$96K |
| 92015 |
Determination of refractive state |
2,224 |
2,190 |
$20K |
| V2020 |
Frames, purchases |
1,749 |
1,711 |
$20K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
435 |
428 |
$19K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
1,046 |
1,018 |
$17K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
550 |
538 |
$8K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
761 |
745 |
$7K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
283 |
275 |
$6K |
| V2200 |
Sphere, bifocal, plano to plus or minus 4.00d, per lens |
17 |
17 |
$683.68 |