| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
414 |
389 |
$48K |
| V2410 |
Variable asphericity lens, single vision, full field, glass or plastic, per lens |
265 |
252 |
$35K |
| V2020 |
Frames, purchases |
361 |
343 |
$13K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
217 |
206 |
$9K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
356 |
337 |
$6K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
354 |
339 |
$5K |
| V2104 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, 2.12 to 4.00d cylinder, per lens |
45 |
43 |
$2K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
16 |
15 |
$592.20 |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
13 |
13 |
$456.20 |
| 92015 |
Determination of refractive state |
418 |
393 |
$314.54 |