| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
978 |
935 |
$48K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
746 |
735 |
$34K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
969 |
865 |
$15K |
| V2020 |
Frames, purchases |
1,540 |
1,420 |
$5K |
| 92015 |
Determination of refractive state |
606 |
586 |
$1K |
| V2025 |
Deluxe frame |
24 |
24 |
$285.00 |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
210 |
197 |
$158.02 |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
407 |
363 |
$0.00 |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
56 |
56 |
$0.00 |