| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
960 |
907 |
$33K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
621 |
559 |
$27K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
279 |
267 |
$15K |
| 92015 |
Determination of refractive state |
1,323 |
1,255 |
$8K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
1,137 |
1,049 |
$7K |
| V2020 |
Frames, purchases |
1,006 |
929 |
$5K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
72 |
68 |
$3K |
| V2025 |
Deluxe frame |
96 |
90 |
$0.00 |
| V2750 |
Anti-reflective coating, per lens |
12 |
12 |
$0.00 |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
17 |
17 |
$0.00 |