| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
470 |
463 |
$45K |
| 92250 |
|
678 |
657 |
$29K |
| V2020 |
Frames, purchases |
396 |
365 |
$18K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
125 |
123 |
$15K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
380 |
351 |
$11K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
298 |
279 |
$6K |
| V2755 |
U-v lens, per lens |
299 |
277 |
$5K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
36 |
16 |
$2K |
| V2410 |
Variable asphericity lens, single vision, full field, glass or plastic, per lens |
16 |
15 |
$800.00 |
| 92015 |
Determination of refractive state |
1,051 |
1,026 |
$790.03 |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
12 |
12 |
$769.40 |