| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
557 |
510 |
$36K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
577 |
520 |
$5K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
46 |
39 |
$3K |
| V2020 |
Frames, purchases |
851 |
769 |
$2K |
| 92015 |
Determination of refractive state |
643 |
592 |
$765.00 |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
602 |
394 |
$179.43 |
| 92341 |
|
25 |
25 |
$135.00 |
| 2022F |
|
327 |
294 |
$51.13 |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
108 |
99 |
$0.00 |
| 92250 |
|
40 |
37 |
$0.00 |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
78 |
67 |
$0.00 |