| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
638 |
630 |
$39K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
427 |
407 |
$33K |
| V2020 |
Frames, purchases |
1,019 |
939 |
$29K |
| 92015 |
Determination of refractive state |
1,238 |
1,189 |
$26K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
793 |
753 |
$20K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
557 |
529 |
$10K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
957 |
897 |
$6K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
188 |
179 |
$2K |
| 92250 |
|
26 |
26 |
$474.72 |
| V2755 |
U-v lens, per lens |
17 |
17 |
$10.00 |