| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
889 |
873 |
$63K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
720 |
706 |
$57K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
1,229 |
1,203 |
$34K |
| V2020 |
Frames, purchases |
1,163 |
1,135 |
$21K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
462 |
410 |
$10K |
| 92015 |
Determination of refractive state |
1,687 |
1,656 |
$9K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
495 |
398 |
$4K |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
41 |
41 |
$3K |
| V2025 |
Deluxe frame |
44 |
44 |
$1K |
| V2104 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, 2.12 to 4.00d cylinder, per lens |
45 |
38 |
$384.32 |