| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
1,216 |
1,070 |
$57K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
887 |
823 |
$43K |
| 92015 |
Determination of refractive state |
2,120 |
1,904 |
$10K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
594 |
292 |
$10K |
| V2020 |
Frames, purchases |
404 |
291 |
$7K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
1,277 |
1,222 |
$6K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
192 |
86 |
$2K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
33 |
27 |
$492.66 |