| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
1,300 |
1,243 |
$87K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
1,877 |
1,753 |
$46K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
419 |
388 |
$27K |
| V2020 |
Frames, purchases |
2,256 |
2,109 |
$27K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
877 |
812 |
$25K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
987 |
920 |
$16K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
127 |
126 |
$2K |
| V2104 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, 2.12 to 4.00d cylinder, per lens |
53 |
51 |
$711.75 |