| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
1,115 |
1,008 |
$36K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
923 |
759 |
$24K |
| 92015 |
Determination of refractive state |
1,383 |
1,233 |
$7K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
1,290 |
1,152 |
$6K |
| V2020 |
Frames, purchases |
840 |
777 |
$6K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
149 |
130 |
$5K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
129 |
115 |
$3K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
14 |
12 |
$0.00 |
| V2025 |
Deluxe frame |
335 |
297 |
$0.00 |