| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
291 |
284 |
$17K |
| V2020 |
Frames, purchases |
1,234 |
1,190 |
$6K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
130 |
125 |
$4K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
367 |
185 |
$3K |
| 92002 |
|
75 |
74 |
$3K |
| V2219 |
Bifocal seg width over 28 mm |
28 |
28 |
$2K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
122 |
119 |
$2K |
| 92341 |
|
79 |
77 |
$2K |
| V2203 |
Spherocylinder, bifocal, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
53 |
52 |
$1K |
| V2199 |
Not otherwise classified, single vision lens |
156 |
78 |
$1K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
96 |
84 |
$858.00 |
| V2200 |
Sphere, bifocal, plano to plus or minus 4.00d, per lens |
23 |
12 |
$114.32 |
| V2755 |
U-v lens, per lens |
384 |
190 |
$0.00 |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
582 |
289 |
$0.00 |