| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
474 |
450 |
$20K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
199 |
192 |
$9K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
484 |
477 |
$7K |
| 92015 |
Determination of refractive state |
606 |
576 |
$4K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
473 |
469 |
$2.50 |
| S0516 |
Safety eyeglass frames |
13 |
13 |
$0.00 |
| V2020 |
Frames, purchases |
469 |
463 |
$0.00 |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
377 |
372 |
$0.00 |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
52 |
52 |
$0.00 |
| S0504 |
Single vision prescription lens (safety, athletic, or sunglass), per lens |
14 |
14 |
$0.00 |