| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
1,368 |
1,311 |
$89K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
2,530 |
2,415 |
$75K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
625 |
589 |
$42K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
1,287 |
1,231 |
$38K |
| V2020 |
Frames, purchases |
2,661 |
2,562 |
$32K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
1,027 |
985 |
$17K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
128 |
121 |
$2K |
| V2782 |
Lens, index 1.54 to 1.65 plastic or 1.60 to 1.79 glass, excludes polycarbonate, per lens |
25 |
25 |
$1K |
| 92015 |
Determination of refractive state |
32 |
32 |
$516.08 |