| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
2,352 |
2,350 |
$104K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
1,964 |
1,961 |
$42K |
| 92015 |
Determination of refractive state |
2,727 |
2,722 |
$27K |
| V2020 |
Frames, purchases |
2,974 |
2,971 |
$20K |
| 92341 |
|
401 |
401 |
$12K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
702 |
701 |
$7K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
84 |
84 |
$2K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
247 |
247 |
$1K |
| V2203 |
Spherocylinder, bifocal, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
104 |
104 |
$1K |
| V2025 |
Deluxe frame |
66 |
66 |
$1K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
31 |
31 |
$1K |