| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
1,514 |
1,475 |
$122K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
587 |
574 |
$59K |
| V2020 |
Frames, purchases |
1,306 |
1,222 |
$48K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
929 |
835 |
$41K |
| 92015 |
Determination of refractive state |
2,495 |
2,425 |
$30K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
1,042 |
981 |
$22K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
430 |
394 |
$13K |
| 92370 |
|
28 |
27 |
$568.43 |