| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
2,362 |
2,220 |
$91K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
1,695 |
1,573 |
$67K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
518 |
494 |
$35K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
611 |
569 |
$22K |
| V2020 |
Frames, purchases |
1,861 |
1,713 |
$14K |
| 92015 |
Determination of refractive state |
2,854 |
2,673 |
$13K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
2,484 |
2,296 |
$11K |
| V2104 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, 2.12 to 4.00d cylinder, per lens |
56 |
53 |
$1K |
| 92341 |
|
12 |
12 |
$14.50 |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
275 |
259 |
$0.00 |
| V2750 |
Anti-reflective coating, per lens |
87 |
81 |
$0.00 |
| V2025 |
Deluxe frame |
922 |
846 |
$-236.00 |