| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
1,759 |
1,647 |
$76K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
2,024 |
1,800 |
$59K |
| 92015 |
Determination of refractive state |
3,246 |
2,978 |
$58K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
1,260 |
1,138 |
$57K |
| V2025 |
Deluxe frame |
1,163 |
1,089 |
$36K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
2,020 |
1,812 |
$33K |
| V2020 |
Frames, purchases |
1,426 |
1,276 |
$13K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
1,567 |
1,388 |
$12K |
| 92341 |
|
128 |
123 |
$4K |
| V2200 |
Sphere, bifocal, plano to plus or minus 4.00d, per lens |
169 |
160 |
$4K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
80 |
78 |
$906.50 |