| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
1,284 |
1,252 |
$80K |
| V2020 |
Frames, purchases |
2,405 |
2,382 |
$33K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
1,632 |
932 |
$30K |
| 92250 |
|
234 |
220 |
$9K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
80 |
80 |
$4K |
| 92285 |
|
155 |
133 |
$4K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
1,563 |
797 |
$1K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
71 |
69 |
$1K |
| 92015 |
Determination of refractive state |
200 |
186 |
$952.00 |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
56 |
27 |
$739.12 |
| V2755 |
U-v lens, per lens |
620 |
310 |
$0.00 |