| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
756 |
724 |
$55K |
| V2020 |
Frames, purchases |
1,229 |
1,182 |
$30K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
1,083 |
1,036 |
$17K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
1,187 |
1,140 |
$17K |
| 92015 |
Determination of refractive state |
927 |
886 |
$7K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
68 |
66 |
$4K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
789 |
753 |
$3K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
79 |
76 |
$161.36 |