| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
1,005 |
923 |
$60K |
| V2020 |
Frames, purchases |
1,934 |
1,676 |
$59K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
730 |
674 |
$55K |
| 92015 |
Determination of refractive state |
1,768 |
1,631 |
$38K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
892 |
870 |
$23K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
1,177 |
1,003 |
$22K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
1,973 |
1,711 |
$11K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
333 |
307 |
$3K |
| 92341 |
|
38 |
38 |
$1K |
| V2203 |
Spherocylinder, bifocal, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
13 |
13 |
$378.96 |