| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
665 |
658 |
$20K |
| V2020 |
Frames, purchases |
1,223 |
1,218 |
$10K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
355 |
355 |
$9K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
546 |
539 |
$6K |
| 92015 |
Determination of refractive state |
851 |
848 |
$2K |
| V2200 |
Sphere, bifocal, plano to plus or minus 4.00d, per lens |
34 |
33 |
$286.00 |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
190 |
189 |
$200.00 |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
26 |
26 |
$0.00 |