| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
907 |
907 |
$38K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
491 |
491 |
$19K |
| V2020 |
Frames, purchases |
1,460 |
1,447 |
$14K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
802 |
404 |
$13K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
314 |
157 |
$6K |
| 92015 |
Determination of refractive state |
1,477 |
1,477 |
$6K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
301 |
295 |
$4K |
| 92250 |
|
13 |
13 |
$718.12 |
| 92145 |
|
13 |
13 |
$123.50 |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
1,418 |
705 |
$20.00 |