| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
2,386 |
2,263 |
$84K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
1,845 |
1,726 |
$74K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
750 |
717 |
$46K |
| 92015 |
Determination of refractive state |
3,104 |
2,963 |
$18K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
2,420 |
2,274 |
$12K |
| V2020 |
Frames, purchases |
1,714 |
1,607 |
$12K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
225 |
206 |
$6K |
| V2104 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, 2.12 to 4.00d cylinder, per lens |
28 |
25 |
$1K |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
201 |
199 |
$1K |
| V2750 |
Anti-reflective coating, per lens |
98 |
92 |
$0.00 |
| 92341 |
|
13 |
12 |
$0.00 |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
295 |
282 |
$0.00 |
| 92310 |
|
14 |
14 |
$0.00 |
| V2025 |
Deluxe frame |
1,043 |
976 |
$-181.00 |