| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
1,940 |
1,777 |
$95K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
723 |
630 |
$41K |
| V2020 |
Frames, purchases |
900 |
863 |
$19K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
314 |
313 |
$9K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
411 |
379 |
$8K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
574 |
568 |
$5K |
| 92250 |
|
54 |
54 |
$2K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
137 |
137 |
$2K |
| 92015 |
Determination of refractive state |
762 |
755 |
$20.22 |