| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
1,063 |
991 |
$48K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
516 |
493 |
$25K |
| 92015 |
Determination of refractive state |
1,694 |
1,588 |
$13K |
| V2020 |
Frames, purchases |
404 |
346 |
$7K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
740 |
717 |
$6K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
422 |
215 |
$5K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
140 |
108 |
$959.02 |
| 92341 |
|
16 |
16 |
$466.40 |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
30 |
30 |
$388.14 |