| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
11,613 |
11,612 |
$351K |
| V2020 |
Frames, purchases |
6,294 |
6,292 |
$95K |
| 92015 |
Determination of refractive state |
13,570 |
13,564 |
$80K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
6,235 |
6,231 |
$72K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
2,710 |
2,707 |
$55K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
1,909 |
1,906 |
$45K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
3,555 |
3,553 |
$25K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
554 |
553 |
$11K |
| V2104 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, 2.12 to 4.00d cylinder, per lens |
69 |
69 |
$888.28 |
| 2025F |
|
12 |
12 |
$0.00 |
| 3072F |
|
229 |
227 |
$0.00 |