| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
923 |
854 |
$40K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
615 |
572 |
$27K |
| V2020 |
Frames, purchases |
1,049 |
979 |
$18K |
| 92015 |
Determination of refractive state |
1,759 |
1,637 |
$8K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
744 |
714 |
$4K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
275 |
126 |
$3K |
| V2203 |
Spherocylinder, bifocal, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
65 |
37 |
$2K |
| V2200 |
Sphere, bifocal, plano to plus or minus 4.00d, per lens |
47 |
26 |
$1K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
89 |
43 |
$566.84 |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
25 |
12 |
$219.57 |