| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
1,662 |
1,557 |
$62K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
318 |
313 |
$22K |
| V2020 |
Frames, purchases |
259 |
250 |
$22K |
| 92015 |
Determination of refractive state |
2,602 |
2,429 |
$22K |
| 92250 |
|
406 |
380 |
$16K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
199 |
189 |
$5K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
74 |
73 |
$5K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
35 |
35 |
$3K |
| V2756 |
Eye glass case |
43 |
37 |
$55.74 |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
68 |
68 |
$0.00 |
| V2025 |
Deluxe frame |
134 |
131 |
$0.00 |