| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
730 |
709 |
$29K |
| 92015 |
Determination of refractive state |
867 |
840 |
$8K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
266 |
260 |
$6K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
93 |
91 |
$5K |
| V2020 |
Frames, purchases |
637 |
625 |
$4K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
502 |
481 |
$1K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
158 |
155 |
$903.00 |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
34 |
28 |
$396.18 |