| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
1,692 |
1,532 |
$62K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
1,042 |
882 |
$29K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
368 |
333 |
$19K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
616 |
517 |
$16K |
| 92015 |
Determination of refractive state |
2,096 |
1,901 |
$10K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
1,804 |
1,606 |
$10K |
| V2020 |
Frames, purchases |
1,299 |
1,167 |
$7K |
| V2025 |
Deluxe frame |
637 |
566 |
$0.00 |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
47 |
45 |
$0.00 |
| V2756 |
Eye glass case |
17 |
17 |
$0.00 |
| 92342 |
|
17 |
17 |
$0.00 |