| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
730 |
347 |
$17K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
160 |
133 |
$5K |
| 92015 |
Determination of refractive state |
1,099 |
603 |
$4K |
| V2020 |
Frames, purchases |
991 |
538 |
$3K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
184 |
172 |
$2K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
364 |
142 |
$365.95 |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
19 |
19 |
$208.43 |
| 2023F |
|
22 |
13 |
$0.01 |
| 92250 |
|
458 |
185 |
$0.00 |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
65 |
59 |
$0.00 |
| 1000F |
|
356 |
150 |
$0.00 |