| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
2,256 |
2,241 |
$92K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
4,690 |
4,655 |
$79K |
| 92015 |
Determination of refractive state |
2,944 |
2,926 |
$28K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
545 |
536 |
$21K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
3,258 |
3,223 |
$300.00 |
| V2020 |
Frames, purchases |
3,345 |
3,305 |
$160.00 |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
1,515 |
1,496 |
$116.00 |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
861 |
857 |
$0.00 |
| V2104 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, 2.12 to 4.00d cylinder, per lens |
72 |
72 |
$0.00 |
| S0504 |
Single vision prescription lens (safety, athletic, or sunglass), per lens |
16 |
16 |
$0.00 |
| 2023F |
|
12 |
12 |
$0.00 |
| S0516 |
Safety eyeglass frames |
16 |
16 |
$0.00 |
| V2107 |
Spherocylinder, single vision, plus or minus 4.25 to plus or minus 7.00 sphere, .12 to 2.00d cylinder, per lens |
15 |
15 |
$0.00 |