| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
682 |
553 |
$37K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
466 |
388 |
$34K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
2,081 |
1,766 |
$31K |
| 92015 |
Determination of refractive state |
2,456 |
2,104 |
$18K |
| V2020 |
Frames, purchases |
475 |
442 |
$10K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
468 |
441 |
$7K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
87 |
77 |
$1.47 |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
14 |
14 |
$0.21 |