| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
1,436 |
1,120 |
$41K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
1,039 |
805 |
$30K |
| 92015 |
Determination of refractive state |
1,849 |
1,456 |
$16K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
342 |
269 |
$15K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
1,519 |
1,177 |
$12K |
| V2020 |
Frames, purchases |
1,180 |
906 |
$11K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
399 |
296 |
$9K |
| V2104 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, 2.12 to 4.00d cylinder, per lens |
18 |
15 |
$150.00 |
| V2025 |
Deluxe frame |
465 |
370 |
$-116.00 |