| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
771 |
626 |
$30K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
249 |
211 |
$17K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
665 |
536 |
$13K |
| V2020 |
Frames, purchases |
786 |
642 |
$4K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
220 |
173 |
$4K |
| V2599 |
Contact lens, other type |
12 |
12 |
$1K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
941 |
760 |
$412.62 |
| V2104 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, 2.12 to 4.00d cylinder, per lens |
15 |
13 |
$405.90 |
| 92015 |
Determination of refractive state |
963 |
779 |
$65.00 |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
71 |
66 |
$0.00 |
| 92310 |
|
21 |
16 |
$0.00 |
| V2025 |
Deluxe frame |
149 |
124 |
$0.00 |
| V2750 |
Anti-reflective coating, per lens |
38 |
34 |
$0.00 |