| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
132 |
132 |
$9K |
| V2020 |
Frames, purchases |
521 |
470 |
$7K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
337 |
317 |
$6K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
485 |
434 |
$6K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
67 |
66 |
$2K |
| V2410 |
Variable asphericity lens, single vision, full field, glass or plastic, per lens |
237 |
207 |
$2K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
159 |
157 |
$1K |
| V2104 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, 2.12 to 4.00d cylinder, per lens |
46 |
45 |
$567.50 |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
17 |
14 |
$130.00 |
| 92015 |
Determination of refractive state |
79 |
78 |
$0.00 |