| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
387 |
372 |
$28K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
82 |
78 |
$7K |
| V2020 |
Frames, purchases |
553 |
496 |
$3K |
| 92015 |
Determination of refractive state |
572 |
514 |
$3K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
327 |
305 |
$2K |
| 92341 |
|
187 |
178 |
$1K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
339 |
306 |
$1K |
| V2203 |
Spherocylinder, bifocal, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
24 |
19 |
$701.06 |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
31 |
28 |
$557.08 |
| V2755 |
U-v lens, per lens |
16 |
13 |
$169.96 |
| V2200 |
Sphere, bifocal, plano to plus or minus 4.00d, per lens |
27 |
13 |
$0.00 |
| V2025 |
Deluxe frame |
55 |
30 |
$0.00 |