| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
2,778 |
2,759 |
$255K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
2,085 |
2,061 |
$161K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
2,792 |
2,750 |
$76K |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
647 |
647 |
$47K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
1,356 |
1,330 |
$46K |
| V2020 |
Frames, purchases |
1,936 |
1,908 |
$34K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
993 |
983 |
$30K |
| 92015 |
Determination of refractive state |
4,303 |
4,270 |
$22K |
| V2025 |
Deluxe frame |
654 |
652 |
$15K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
1,027 |
1,019 |
$11K |
| V2104 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, 2.12 to 4.00d cylinder, per lens |
195 |
194 |
$2K |