| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
1,105 |
980 |
$60K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
303 |
269 |
$20K |
| V2020 |
Frames, purchases |
1,238 |
1,049 |
$18K |
| 92015 |
Determination of refractive state |
1,670 |
1,470 |
$14K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
950 |
820 |
$11K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
393 |
330 |
$11K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
324 |
243 |
$8K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
13 |
13 |
$757.46 |
| V2799 |
Vision item or service, miscellaneous |
19 |
15 |
$182.84 |
| 92341 |
|
25 |
12 |
$135.96 |
| 3072F |
|
22 |
22 |
$0.00 |