| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
1,150 |
1,149 |
$50K |
| V2020 |
Frames, purchases |
1,075 |
1,071 |
$41K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
705 |
702 |
$30K |
| 92015 |
Determination of refractive state |
1,880 |
1,870 |
$27K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
609 |
603 |
$18K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
1,054 |
1,051 |
$13K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
550 |
548 |
$6K |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
76 |
76 |
$3K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
138 |
138 |
$3K |
| V2104 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, 2.12 to 4.00d cylinder, per lens |
66 |
66 |
$612.48 |