| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
2,149 |
2,127 |
$151K |
| V2020 |
Frames, purchases |
3,047 |
3,016 |
$95K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
918 |
910 |
$77K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
2,233 |
2,208 |
$44K |
| 92250 |
|
1,941 |
1,912 |
$43K |
| 92015 |
Determination of refractive state |
3,602 |
3,561 |
$40K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
1,645 |
1,614 |
$17K |
| 92134 |
|
759 |
750 |
$17K |
| 92370 |
|
598 |
583 |
$11K |
| 92133 |
|
291 |
288 |
$6K |
| 92341 |
|
32 |
31 |
$712.38 |
| V2203 |
Spherocylinder, bifocal, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
31 |
30 |
$432.88 |
| V2104 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, 2.12 to 4.00d cylinder, per lens |
14 |
12 |
$138.71 |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
14 |
14 |
$109.16 |