| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
1,189 |
948 |
$82K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
998 |
760 |
$26K |
| V2020 |
Frames, purchases |
1,663 |
1,245 |
$25K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
1,494 |
1,082 |
$20K |
| 92015 |
Determination of refractive state |
1,480 |
1,106 |
$20K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
223 |
215 |
$14K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
189 |
119 |
$9K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
158 |
102 |
$2K |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
127 |
126 |
$1K |
| 3072F |
|
316 |
313 |
$0.00 |
| V2756 |
Eye glass case |
119 |
114 |
$0.00 |
| V2760 |
Scratch resistant coating, per lens |
1,188 |
797 |
$0.00 |