| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
1,317 |
1,295 |
$110K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
1,735 |
1,667 |
$41K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
422 |
419 |
$38K |
| 92015 |
Determination of refractive state |
3,215 |
3,166 |
$37K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
714 |
382 |
$19K |
| V2020 |
Frames, purchases |
444 |
419 |
$13K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
124 |
72 |
$2K |
| V2410 |
Variable asphericity lens, single vision, full field, glass or plastic, per lens |
164 |
82 |
$2K |
| 1036F |
|
162 |
160 |
$0.00 |
| V2745 |
Addition to lens; tint, any color, solid, gradient or equal, excludes photochromatic, any lens material, per lens |
32 |
16 |
$0.00 |