| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
2,760 |
2,754 |
$132K |
| V2020 |
Frames, purchases |
3,440 |
3,423 |
$73K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
2,974 |
2,960 |
$63K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
1,390 |
1,382 |
$52K |
| 92015 |
Determination of refractive state |
4,399 |
4,382 |
$35K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
2,348 |
2,077 |
$24K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
1,786 |
1,762 |
$20K |
| 92341 |
|
172 |
172 |
$3K |
| V2203 |
Spherocylinder, bifocal, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
97 |
71 |
$3K |
| V2104 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, 2.12 to 4.00d cylinder, per lens |
15 |
15 |
$297.92 |