| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
1,156 |
1,079 |
$57K |
| V2020 |
Frames, purchases |
1,019 |
930 |
$30K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
190 |
176 |
$11K |
| 92015 |
Determination of refractive state |
1,384 |
1,276 |
$3K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
638 |
600 |
$3K |
| V2313 |
Spherocylinder, trifocal, plus or minus 7.25 to plus or minus 12.00d sphere, 4.25 to 6.00d cylinder, per lens |
78 |
77 |
$563.18 |
| 92341 |
|
122 |
117 |
$458.28 |
| V2314 |
Spherocylinder, trifocal, sphere over plus or minus 12.00d, per lens |
80 |
77 |
$283.34 |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
204 |
167 |
$133.72 |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
14 |
13 |
$128.27 |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
68 |
66 |
$0.00 |
| V2755 |
U-v lens, per lens |
29 |
13 |
$0.00 |