| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
543 |
490 |
$23K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
312 |
203 |
$17K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
341 |
309 |
$14K |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
259 |
189 |
$12K |
| V2020 |
Frames, purchases |
354 |
349 |
$12K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
464 |
463 |
$11K |
| 92015 |
Determination of refractive state |
756 |
742 |
$10K |
| V2025 |
Deluxe frame |
231 |
141 |
$3K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
202 |
202 |
$2K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
126 |
126 |
$1K |