| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
960 |
910 |
$76K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
1,829 |
1,696 |
$39K |
| V2020 |
Frames, purchases |
1,107 |
986 |
$33K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
583 |
514 |
$23K |
| 92015 |
Determination of refractive state |
1,416 |
1,346 |
$16K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
718 |
626 |
$14K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
109 |
103 |
$8K |
| 92250 |
|
28 |
28 |
$626.36 |