| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
896 |
855 |
$46K |
| V2020 |
Frames, purchases |
1,174 |
1,116 |
$39K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
400 |
395 |
$20K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
1,133 |
1,072 |
$12K |
| 92015 |
Determination of refractive state |
1,332 |
1,282 |
$12K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
654 |
634 |
$9K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
120 |
114 |
$715.00 |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
301 |
277 |
$252.51 |
| 92341 |
|
14 |
14 |
$210.00 |
| V2200 |
Sphere, bifocal, plano to plus or minus 4.00d, per lens |
13 |
13 |
$203.58 |
| 3072F |
|
15 |
15 |
$150.00 |