| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
955 |
668 |
$17K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
556 |
394 |
$11K |
| 92015 |
Determination of refractive state |
876 |
687 |
$5K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
855 |
609 |
$4K |
| V2020 |
Frames, purchases |
557 |
375 |
$2K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
67 |
44 |
$808.66 |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
69 |
53 |
$633.79 |
| V2025 |
Deluxe frame |
205 |
141 |
$0.00 |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
152 |
75 |
$0.00 |