| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
2,207 |
2,064 |
$112K |
| V2020 |
Frames, purchases |
4,002 |
3,560 |
$92K |
| 92015 |
Determination of refractive state |
3,346 |
3,101 |
$65K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
1,226 |
1,173 |
$59K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
2,131 |
1,710 |
$39K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
3,910 |
3,477 |
$23K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
620 |
580 |
$12K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
706 |
627 |
$10K |
| 92341 |
|
13 |
13 |
$304.15 |
| V2203 |
Spherocylinder, bifocal, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
12 |
12 |
$258.00 |
| V2200 |
Sphere, bifocal, plano to plus or minus 4.00d, per lens |
12 |
12 |
$195.50 |