| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
1,157 |
1,121 |
$51K |
| 92015 |
Determination of refractive state |
1,679 |
1,627 |
$26K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
707 |
658 |
$21K |
| V2020 |
Frames, purchases |
491 |
491 |
$17K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
325 |
316 |
$14K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
310 |
310 |
$4K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
169 |
169 |
$2K |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
12 |
12 |
$495.00 |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
14 |
14 |
$153.70 |