| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
1,284 |
1,275 |
$58K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
1,346 |
1,338 |
$57K |
| 92015 |
Determination of refractive state |
2,564 |
2,553 |
$41K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
1,003 |
988 |
$30K |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
475 |
366 |
$21K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
297 |
277 |
$16K |
| V2020 |
Frames, purchases |
438 |
423 |
$11K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
262 |
256 |
$3K |
| V2025 |
Deluxe frame |
72 |
72 |
$777.60 |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
61 |
61 |
$740.16 |