| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
970 |
926 |
$44K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
995 |
935 |
$28K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
90 |
87 |
$6K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
1,346 |
1,270 |
$5K |
| V2020 |
Frames, purchases |
1,173 |
1,124 |
$4K |
| 92015 |
Determination of refractive state |
1,408 |
1,353 |
$4K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
14 |
12 |
$109.50 |
| V2025 |
Deluxe frame |
94 |
83 |
$0.00 |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
33 |
33 |
$0.00 |