| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
435 |
404 |
$32K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
594 |
450 |
$31K |
| V2020 |
Frames, purchases |
1,031 |
834 |
$4K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
560 |
499 |
$3K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
746 |
426 |
$2K |
| 92015 |
Determination of refractive state |
1,309 |
1,080 |
$857.50 |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
256 |
220 |
$462.50 |
| 2022F |
|
130 |
103 |
$212.18 |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
107 |
59 |
$2.50 |
| V2025 |
Deluxe frame |
14 |
13 |
$0.00 |
| 92250 |
|
19 |
17 |
$0.00 |