| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
1,030 |
989 |
$66K |
| 92015 |
Determination of refractive state |
1,567 |
1,507 |
$56K |
| V2020 |
Frames, purchases |
1,508 |
1,452 |
$42K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
1,205 |
1,171 |
$40K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
1,506 |
1,449 |
$31K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
374 |
366 |
$19K |
| S0580 |
Polycarbonate lens (list this code in addition to the basic code for the lens) |
528 |
514 |
$15K |
| 92250 |
|
69 |
64 |
$3K |
| V2203 |
Spherocylinder, bifocal, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
13 |
12 |
$573.85 |