| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
1,206 |
1,200 |
$54K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
914 |
906 |
$43K |
| 92015 |
Determination of refractive state |
2,128 |
2,118 |
$40K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
1,679 |
1,662 |
$36K |
| V2020 |
Frames, purchases |
2,350 |
2,331 |
$7K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
563 |
560 |
$6K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
2,057 |
2,044 |
$1K |
| 92341 |
|
40 |
40 |
$1K |
| V2200 |
Sphere, bifocal, plano to plus or minus 4.00d, per lens |
38 |
38 |
$1K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
1,059 |
1,053 |
$0.00 |
| V2203 |
Spherocylinder, bifocal, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
12 |
12 |
$0.00 |