| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
514 |
489 |
$42K |
| V2020 |
Frames, purchases |
250 |
239 |
$9K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
86 |
76 |
$8K |
| V2410 |
Variable asphericity lens, single vision, full field, glass or plastic, per lens |
31 |
30 |
$5K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
309 |
297 |
$5K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
192 |
180 |
$3K |
| 92015 |
Determination of refractive state |
1,268 |
1,181 |
$1K |
| 92250 |
|
15 |
12 |
$634.43 |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
14 |
14 |
$488.67 |