| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
1,113 |
1,028 |
$43K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
517 |
486 |
$31K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
842 |
765 |
$29K |
| 92015 |
Determination of refractive state |
1,667 |
1,546 |
$12K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
1,302 |
1,171 |
$9K |
| V2020 |
Frames, purchases |
1,097 |
991 |
$8K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
159 |
135 |
$5K |
| 92341 |
|
12 |
12 |
$188.50 |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
13 |
12 |
$0.00 |
| V2025 |
Deluxe frame |
290 |
268 |
$0.00 |