| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
725 |
716 |
$26K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
1,119 |
1,100 |
$16K |
| 92015 |
Determination of refractive state |
1,324 |
1,265 |
$8K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
166 |
165 |
$6K |
| V2020 |
Frames, purchases |
1,336 |
1,284 |
$2K |
| 92370 |
|
65 |
43 |
$249.90 |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
1,210 |
1,192 |
$0.00 |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
743 |
731 |
$0.00 |
| V2104 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, 2.12 to 4.00d cylinder, per lens |
12 |
12 |
$0.00 |