| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
414 |
379 |
$19K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
165 |
151 |
$9K |
| V2020 |
Frames, purchases |
371 |
330 |
$6K |
| S0621 |
Routine ophthalmological examination including refraction; established patient |
31 |
31 |
$3K |
| 92015 |
Determination of refractive state |
549 |
511 |
$2K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
189 |
182 |
$1K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
81 |
49 |
$1K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
30 |
28 |
$440.10 |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
38 |
28 |
$245.02 |