| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
1,260 |
1,253 |
$52K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
1,659 |
1,646 |
$31K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
447 |
442 |
$19K |
| 92015 |
Determination of refractive state |
1,631 |
1,624 |
$18K |
| V2020 |
Frames, purchases |
1,440 |
1,428 |
$160.00 |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
656 |
650 |
$63.00 |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
296 |
296 |
$53.00 |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
1,314 |
1,302 |
$5.00 |