| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
1,902 |
1,812 |
$75K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
1,263 |
1,202 |
$52K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
211 |
207 |
$15K |
| 92015 |
Determination of refractive state |
2,351 |
2,261 |
$12K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
1,893 |
1,793 |
$11K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
228 |
211 |
$9K |
| V2020 |
Frames, purchases |
1,237 |
1,172 |
$8K |
| V2104 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, 2.12 to 4.00d cylinder, per lens |
40 |
38 |
$1K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
237 |
224 |
$5.00 |
| V2025 |
Deluxe frame |
932 |
890 |
$0.00 |
| V2750 |
Anti-reflective coating, per lens |
118 |
108 |
$0.00 |