| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
548 |
536 |
$34K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
284 |
281 |
$17K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
696 |
676 |
$3K |
| V2020 |
Frames, purchases |
723 |
701 |
$806.00 |
| 92015 |
Determination of refractive state |
749 |
726 |
$96.50 |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
435 |
363 |
$11.00 |
| V2025 |
Deluxe frame |
39 |
39 |
$0.00 |
| 2021F |
|
39 |
39 |
$0.00 |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
142 |
104 |
$0.00 |
| V2756 |
Eye glass case |
72 |
72 |
$0.00 |
| 92342 |
|
73 |
72 |
$0.00 |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
12 |
12 |
$0.00 |