| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
477 |
435 |
$42K |
| V2020 |
Frames, purchases |
1,153 |
1,082 |
$37K |
| 92015 |
Determination of refractive state |
1,161 |
1,098 |
$25K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
1,019 |
961 |
$17K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
520 |
477 |
$13K |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
14 |
14 |
$1K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
12 |
12 |
$465.53 |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
14 |
12 |
$407.44 |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
50 |
50 |
$0.00 |