| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
986 |
960 |
$46K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
1,548 |
803 |
$32K |
| V2020 |
Frames, purchases |
1,911 |
1,893 |
$23K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
358 |
353 |
$18K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
82 |
41 |
$2K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
3,297 |
1,638 |
$1K |
| 92015 |
Determination of refractive state |
421 |
413 |
$951.90 |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
13 |
13 |
$195.00 |