| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
500 |
415 |
$43K |
| V2020 |
Frames, purchases |
996 |
743 |
$24K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
826 |
657 |
$16K |
| 92015 |
Determination of refractive state |
1,065 |
817 |
$12K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
172 |
166 |
$12K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
115 |
113 |
$3K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
63 |
55 |
$2K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
38 |
38 |
$598.50 |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
12 |
12 |
$584.88 |
| 2023F |
|
18 |
18 |
$0.00 |
| V2025 |
Deluxe frame |
484 |
279 |
$0.00 |