| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
503 |
495 |
$40K |
| 92015 |
Determination of refractive state |
1,205 |
1,045 |
$39K |
| V2020 |
Frames, purchases |
1,200 |
1,089 |
$37K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
1,130 |
1,024 |
$16K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
310 |
252 |
$6K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
43 |
43 |
$5K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
103 |
98 |
$3K |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
44 |
42 |
$3K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
132 |
92 |
$892.11 |
| 92002 |
|
13 |
13 |
$830.04 |
| V2101 |
Sphere, single vision, plus or minus 4.12 to plus or minus 7.00d, per lens |
13 |
13 |
$478.40 |