| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
407 |
383 |
$18K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
239 |
232 |
$18K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
368 |
349 |
$9K |
| V2020 |
Frames, purchases |
490 |
453 |
$1K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
45 |
41 |
$481.00 |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
541 |
501 |
$123.50 |
| 92015 |
Determination of refractive state |
630 |
603 |
$40.00 |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
54 |
51 |
$5.00 |
| V2025 |
Deluxe frame |
53 |
48 |
$0.00 |
| 92341 |
|
13 |
13 |
$0.00 |