| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
985 |
976 |
$38K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
2,438 |
1,463 |
$21K |
| 92015 |
Determination of refractive state |
1,463 |
1,448 |
$10K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
112 |
112 |
$4K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
29 |
19 |
$195.00 |
| V2020 |
Frames, purchases |
2,122 |
1,133 |
$61.50 |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
1,513 |
1,038 |
$45.02 |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
77 |
73 |
$0.00 |