| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
1,327 |
1,296 |
$57K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
827 |
813 |
$34K |
| 92015 |
Determination of refractive state |
2,349 |
2,281 |
$30K |
| V2020 |
Frames, purchases |
1,465 |
1,434 |
$26K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
958 |
936 |
$19K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
965 |
557 |
$8K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
308 |
301 |
$7K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
1,271 |
1,249 |
$6K |
| 92341 |
|
161 |
154 |
$4K |
| V2203 |
Spherocylinder, bifocal, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
30 |
18 |
$384.00 |