| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
2,651 |
2,613 |
$232K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
2,726 |
2,687 |
$122K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
4,681 |
4,605 |
$91K |
| V2020 |
Frames, purchases |
3,199 |
3,162 |
$80K |
| V2025 |
Deluxe frame |
1,365 |
1,350 |
$68K |
| V2105 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, 4.25 to 6.00d cylinder, per lens |
1,239 |
1,210 |
$32K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
279 |
276 |
$24K |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
290 |
290 |
$21K |
| 92015 |
Determination of refractive state |
2,986 |
2,938 |
$17K |
| V2200 |
Sphere, bifocal, plano to plus or minus 4.00d, per lens |
42 |
42 |
$2K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
200 |
200 |
$2K |
| V2104 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, 2.12 to 4.00d cylinder, per lens |
54 |
54 |
$462.08 |
| V2799 |
Vision item or service, miscellaneous |
28 |
28 |
$0.00 |