| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| V2020 |
Frames, purchases |
2,100 |
2,100 |
$54K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
739 |
704 |
$42K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
514 |
495 |
$23K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
1,033 |
1,031 |
$18K |
| 92341 |
|
888 |
888 |
$18K |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
405 |
394 |
$14K |
| 92015 |
Determination of refractive state |
1,500 |
1,439 |
$11K |
| V2203 |
Spherocylinder, bifocal, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
709 |
709 |
$10K |
| 92083 |
|
391 |
383 |
$10K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
593 |
592 |
$6K |
| 92133 |
|
277 |
269 |
$4K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
12 |
12 |
$204.40 |