| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
1,400 |
1,335 |
$57K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
847 |
830 |
$36K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
650 |
629 |
$15K |
| V2020 |
Frames, purchases |
685 |
664 |
$7K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
340 |
338 |
$4K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
17 |
17 |
$300.00 |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
98 |
95 |
$0.00 |
| 92015 |
Determination of refractive state |
169 |
167 |
$0.00 |