| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
389 |
362 |
$21K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
346 |
331 |
$19K |
| 92015 |
Determination of refractive state |
795 |
755 |
$3K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
117 |
73 |
$1K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
122 |
97 |
$675.00 |
| V2203 |
Spherocylinder, bifocal, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
25 |
24 |
$638.58 |
| V2020 |
Frames, purchases |
219 |
155 |
$613.98 |
| 92341 |
|
28 |
27 |
$180.00 |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
85 |
52 |
$0.00 |