| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
2,830 |
2,797 |
$113K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
5,567 |
5,496 |
$100K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
973 |
966 |
$44K |
| 92015 |
Determination of refractive state |
3,715 |
3,681 |
$41K |
| V2020 |
Frames, purchases |
4,839 |
4,765 |
$640.00 |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
2,561 |
2,522 |
$569.00 |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
1,258 |
1,231 |
$63.00 |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
4,374 |
4,307 |
$8.00 |
| S0504 |
Single vision prescription lens (safety, athletic, or sunglass), per lens |
23 |
23 |
$0.00 |
| V2744 |
Tint, photochromatic, per lens |
15 |
15 |
$0.00 |
| V2104 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, 2.12 to 4.00d cylinder, per lens |
138 |
138 |
$0.00 |
| V2781 |
Progressive lens, per lens |
26 |
25 |
$0.00 |
| S0516 |
Safety eyeglass frames |
26 |
26 |
$0.00 |
| V2107 |
Spherocylinder, single vision, plus or minus 4.25 to plus or minus 7.00 sphere, .12 to 2.00d cylinder, per lens |
25 |
25 |
$0.00 |
| S0590 |
Integral lens service, miscellaneous services reported separately |
14 |
14 |
$0.00 |