| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
837 |
816 |
$54K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
518 |
506 |
$41K |
| 92015 |
Determination of refractive state |
1,700 |
1,673 |
$25K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
1,230 |
1,206 |
$21K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
1,134 |
1,108 |
$19K |
| V2101 |
Sphere, single vision, plus or minus 4.12 to plus or minus 7.00d, per lens |
983 |
486 |
$6K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
346 |
169 |
$1K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
153 |
82 |
$731.22 |
| V2020 |
Frames, purchases |
30 |
30 |
$262.50 |