| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
631 |
495 |
$41K |
| V2020 |
Frames, purchases |
873 |
771 |
$23K |
| 92015 |
Determination of refractive state |
1,332 |
1,088 |
$22K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
1,129 |
982 |
$18K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
173 |
139 |
$4K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
313 |
278 |
$4K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
64 |
64 |
$2K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
13 |
13 |
$2K |