| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
1,011 |
929 |
$68K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
195 |
184 |
$15K |
| 92015 |
Determination of refractive state |
1,836 |
1,643 |
$10K |
| V2020 |
Frames, purchases |
1,106 |
967 |
$9K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
1,005 |
880 |
$3K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
837 |
772 |
$3K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
978 |
857 |
$894.32 |
| V2755 |
U-v lens, per lens |
16 |
15 |
$0.00 |
| V2756 |
Eye glass case |
20 |
18 |
$0.00 |
| V2745 |
Addition to lens; tint, any color, solid, gradient or equal, excludes photochromatic, any lens material, per lens |
16 |
15 |
$0.00 |