| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
2,118 |
2,073 |
$93K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
2,198 |
2,122 |
$65K |
| 92015 |
Determination of refractive state |
3,330 |
3,249 |
$59K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
938 |
913 |
$44K |
| V2020 |
Frames, purchases |
2,730 |
2,622 |
$34K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
1,742 |
1,640 |
$21K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
1,673 |
1,594 |
$18K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
862 |
856 |
$10K |
| 92341 |
|
230 |
192 |
$7K |
| V2200 |
Sphere, bifocal, plano to plus or minus 4.00d, per lens |
12 |
12 |
$169.79 |
| V2025 |
Deluxe frame |
12 |
12 |
$110.00 |