| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
308 |
297 |
$13K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
165 |
150 |
$11K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
333 |
304 |
$9K |
| V2020 |
Frames, purchases |
426 |
381 |
$2K |
| 92015 |
Determination of refractive state |
811 |
755 |
$2K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
673 |
612 |
$2K |
| V2025 |
Deluxe frame |
59 |
54 |
$0.00 |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
14 |
14 |
$0.00 |