| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
1,226 |
1,058 |
$48K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
623 |
545 |
$26K |
| 92015 |
Determination of refractive state |
1,833 |
1,590 |
$10K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
1,132 |
1,104 |
$8K |
| V2020 |
Frames, purchases |
482 |
326 |
$6K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
378 |
213 |
$6K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
132 |
58 |
$968.50 |
| 92341 |
|
12 |
12 |
$234.96 |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
44 |
12 |
$166.87 |