| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
1,206 |
1,094 |
$75K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
950 |
889 |
$67K |
| V2020 |
Frames, purchases |
1,454 |
1,369 |
$46K |
| 92015 |
Determination of refractive state |
1,872 |
1,720 |
$8K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
1,109 |
1,049 |
$4K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
1,378 |
832 |
$2K |
| 92341 |
|
12 |
12 |
$180.00 |
| V2025 |
Deluxe frame |
14 |
14 |
$0.00 |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
20 |
13 |
$0.00 |
| V2104 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, 2.12 to 4.00d cylinder, per lens |
12 |
12 |
$0.00 |