| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
2,461 |
2,425 |
$187K |
| V2020 |
Frames, purchases |
1,943 |
1,896 |
$55K |
| 92015 |
Determination of refractive state |
4,009 |
3,928 |
$47K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
2,221 |
1,824 |
$45K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
640 |
625 |
$37K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
377 |
369 |
$34K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
811 |
790 |
$18K |
| V2200 |
Sphere, bifocal, plano to plus or minus 4.00d, per lens |
37 |
37 |
$2K |
| 92341 |
|
49 |
49 |
$1K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
47 |
30 |
$562.48 |