| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
496 |
452 |
$27K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
308 |
268 |
$16K |
| V2020 |
Frames, purchases |
736 |
657 |
$8K |
| 92015 |
Determination of refractive state |
829 |
742 |
$7K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
633 |
563 |
$5K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
331 |
279 |
$2K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
212 |
208 |
$998.48 |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
81 |
72 |
$195.77 |
| 92250 |
|
820 |
734 |
$0.00 |