| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
610 |
598 |
$32K |
| V2020 |
Frames, purchases |
1,027 |
983 |
$28K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
230 |
226 |
$11K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
952 |
911 |
$3K |
| 92015 |
Determination of refractive state |
1,198 |
1,173 |
$2K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
753 |
707 |
$1K |
| 92342 |
|
196 |
195 |
$43.36 |
| 2022F |
|
201 |
201 |
$0.00 |
| V2756 |
Eye glass case |
194 |
193 |
$0.00 |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
24 |
12 |
$0.00 |
| 3072F |
|
121 |
121 |
$0.00 |