| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
1,374 |
1,339 |
$75K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
635 |
602 |
$32K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
244 |
237 |
$9K |
| 92015 |
Determination of refractive state |
2,214 |
2,130 |
$5K |
| 1036F |
|
82 |
51 |
$5K |
| V2020 |
Frames, purchases |
320 |
286 |
$1K |
| 2022F |
|
12 |
12 |
$0.00 |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
55 |
36 |
$0.00 |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
75 |
70 |
$0.00 |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
240 |
225 |
$0.00 |