| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
1,322 |
1,314 |
$90K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
948 |
937 |
$86K |
| V2020 |
Frames, purchases |
2,024 |
1,993 |
$59K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
1,249 |
1,233 |
$38K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
1,108 |
1,073 |
$20K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
1,482 |
1,464 |
$15K |
| 92015 |
Determination of refractive state |
2,676 |
2,639 |
$5K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
277 |
268 |
$4K |
| V2760 |
Scratch resistant coating, per lens |
984 |
972 |
$2K |