| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
1,228 |
1,207 |
$121K |
| V2020 |
Frames, purchases |
1,886 |
1,834 |
$63K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
363 |
356 |
$43K |
| 92015 |
Determination of refractive state |
2,325 |
2,239 |
$36K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
1,591 |
1,546 |
$22K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
552 |
544 |
$16K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
438 |
430 |
$15K |
| V2104 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, 2.12 to 4.00d cylinder, per lens |
13 |
13 |
$448.25 |
| 1036F |
|
59 |
57 |
$0.00 |
| G9903 |
Patient screened for tobacco use and identified as a tobacco non-user |
59 |
57 |
$0.00 |