| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| V2020 |
Frames, purchases |
680 |
480 |
$19K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
602 |
367 |
$12K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
420 |
311 |
$6K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
357 |
248 |
$3K |
| 92015 |
Determination of refractive state |
1,395 |
1,001 |
$570.00 |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
669 |
483 |
$360.00 |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
327 |
229 |
$45.00 |
| 92325 |
Contact lens gas impermeable |
43 |
15 |
$0.00 |