| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
1,616 |
1,611 |
$82K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
718 |
712 |
$33K |
| V2020 |
Frames, purchases |
2,452 |
2,397 |
$32K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
1,211 |
1,185 |
$28K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
1,360 |
1,316 |
$13K |
| V2200 |
Sphere, bifocal, plano to plus or minus 4.00d, per lens |
164 |
162 |
$6K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
480 |
472 |
$4K |
| 92015 |
Determination of refractive state |
1,779 |
1,775 |
$2K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
41 |
41 |
$892.57 |