| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
1,291 |
1,277 |
$54K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
909 |
903 |
$20K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
392 |
387 |
$16K |
| V2520 |
Contact lens, hydrophilic, spherical, per lens |
110 |
108 |
$14K |
| V2020 |
Frames, purchases |
237 |
235 |
$4K |
| 92341 |
|
195 |
189 |
$4K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
121 |
121 |
$3K |
| 92015 |
Determination of refractive state |
1,112 |
1,099 |
$1K |
| V2200 |
Sphere, bifocal, plano to plus or minus 4.00d, per lens |
27 |
27 |
$980.20 |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
49 |
49 |
$624.00 |
| 99199 |
Unlisted special service, procedure or report |
24 |
24 |
$0.00 |
| 3072F |
|
263 |
262 |
$0.00 |
| 2023F |
|
750 |
738 |
$0.00 |