| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
1,656 |
1,568 |
$72K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
1,469 |
1,378 |
$55K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
611 |
583 |
$45K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
2,288 |
2,161 |
$11K |
| 92015 |
Determination of refractive state |
2,444 |
2,333 |
$9K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
269 |
250 |
$9K |
| V2020 |
Frames, purchases |
1,985 |
1,880 |
$8K |
| 92341 |
|
15 |
13 |
$14.50 |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
153 |
145 |
$0.00 |
| V2025 |
Deluxe frame |
370 |
349 |
$0.00 |
| V2750 |
Anti-reflective coating, per lens |
20 |
16 |
$0.00 |