| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
1,451 |
1,421 |
$61K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
842 |
824 |
$36K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
1,941 |
1,923 |
$30K |
| V2020 |
Frames, purchases |
1,654 |
1,634 |
$22K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
553 |
547 |
$11K |
| V2025 |
Deluxe frame |
98 |
97 |
$4K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
612 |
602 |
$2K |
| 92015 |
Determination of refractive state |
58 |
58 |
$720.00 |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
434 |
430 |
$42.00 |