| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
1,347 |
1,267 |
$87K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
816 |
746 |
$67K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
1,284 |
1,216 |
$64K |
| V2020 |
Frames, purchases |
483 |
396 |
$10K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
252 |
248 |
$7K |
| 92015 |
Determination of refractive state |
1,996 |
1,839 |
$6K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
154 |
123 |
$954.71 |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
59 |
19 |
$482.64 |
| V2760 |
Scratch resistant coating, per lens |
93 |
93 |
$184.00 |