| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
1,964 |
1,930 |
$119K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
909 |
891 |
$71K |
| 92015 |
Determination of refractive state |
3,217 |
3,149 |
$70K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
2,537 |
2,372 |
$68K |
| V2020 |
Frames, purchases |
1,991 |
1,848 |
$60K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
1,165 |
1,042 |
$22K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
2,001 |
1,858 |
$12K |
| 92341 |
|
74 |
74 |
$3K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
271 |
258 |
$3K |
| 92133 |
|
30 |
30 |
$631.50 |
| V2756 |
Eye glass case |
619 |
566 |
$329.28 |