| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
2,356 |
2,119 |
$98K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
1,045 |
996 |
$69K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
2,164 |
1,993 |
$64K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
2,921 |
2,756 |
$21K |
| V2020 |
Frames, purchases |
2,533 |
2,388 |
$18K |
| 92015 |
Determination of refractive state |
3,276 |
3,092 |
$17K |
| V2104 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, 2.12 to 4.00d cylinder, per lens |
144 |
137 |
$5K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
127 |
117 |
$3K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
224 |
216 |
$15.00 |
| V2025 |
Deluxe frame |
666 |
615 |
$0.00 |
| V2750 |
Anti-reflective coating, per lens |
43 |
40 |
$0.00 |
| 2022F |
|
14 |
14 |
$0.00 |