| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
595 |
593 |
$23K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
318 |
314 |
$14K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
469 |
464 |
$13K |
| 92015 |
Determination of refractive state |
761 |
756 |
$12K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
197 |
196 |
$7K |
| V2020 |
Frames, purchases |
207 |
206 |
$2K |
| V2200 |
Sphere, bifocal, plano to plus or minus 4.00d, per lens |
29 |
29 |
$2K |
| V2025 |
Deluxe frame |
118 |
111 |
$2K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
103 |
102 |
$210.00 |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
15 |
15 |
$0.00 |