| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
1,134 |
1,131 |
$69K |
| V2020 |
Frames, purchases |
1,696 |
1,695 |
$53K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
1,415 |
1,415 |
$29K |
| 92015 |
Determination of refractive state |
1,920 |
1,916 |
$22K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
159 |
159 |
$12K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
385 |
385 |
$5K |
| 92250 |
|
329 |
329 |
$5K |
| 92341 |
|
140 |
139 |
$3K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
24 |
24 |
$279.72 |
| V2203 |
Spherocylinder, bifocal, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
12 |
12 |
$169.80 |