| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
690 |
645 |
$50K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
1,106 |
1,018 |
$28K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
854 |
765 |
$26K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
243 |
243 |
$18K |
| V2020 |
Frames, purchases |
924 |
830 |
$11K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
449 |
428 |
$7K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
201 |
195 |
$3K |
| 92015 |
Determination of refractive state |
173 |
173 |
$2K |