| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
742 |
732 |
$27K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
1,731 |
1,213 |
$15K |
| 92015 |
Determination of refractive state |
1,171 |
1,152 |
$8K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
13 |
13 |
$520.00 |
| V2020 |
Frames, purchases |
1,100 |
1,044 |
$0.00 |
| V2025 |
Deluxe frame |
12 |
12 |
$0.00 |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
719 |
678 |
$0.00 |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
881 |
827 |
$0.00 |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
60 |
59 |
$0.00 |