| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
1,421 |
1,322 |
$137K |
| V2020 |
Frames, purchases |
1,698 |
1,608 |
$57K |
| 92015 |
Determination of refractive state |
1,908 |
1,795 |
$42K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
1,522 |
1,444 |
$21K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
655 |
607 |
$18K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
128 |
123 |
$16K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
408 |
396 |
$15K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
513 |
484 |
$0.00 |
| 1036F |
|
139 |
124 |
$0.00 |