| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
1,350 |
1,275 |
$86K |
| V2020 |
Frames, purchases |
1,924 |
1,574 |
$43K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
1,476 |
1,332 |
$39K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
410 |
396 |
$36K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
738 |
513 |
$8K |
| 92015 |
Determination of refractive state |
1,442 |
1,365 |
$6K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
851 |
616 |
$5K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
145 |
113 |
$2K |
| V2108 |
Spherocylinder, single vision, plus or minus 4.25d to plus or minus 7.00d sphere, 2.12 to 4.00d cylinder, per lens |
106 |
105 |
$2K |
| V2760 |
Scratch resistant coating, per lens |
614 |
557 |
$799.67 |