| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
149 |
148 |
$6K |
| V2020 |
Frames, purchases |
491 |
487 |
$5K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
102 |
102 |
$5K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
209 |
167 |
$4K |
| 92002 |
|
31 |
31 |
$2K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
601 |
379 |
$2K |
| V2200 |
Sphere, bifocal, plano to plus or minus 4.00d, per lens |
29 |
26 |
$1K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
31 |
23 |
$913.64 |
| 92015 |
Determination of refractive state |
32 |
32 |
$552.20 |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
36 |
36 |
$15.00 |