| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
1,883 |
1,734 |
$156K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
720 |
680 |
$45K |
| V2020 |
Frames, purchases |
457 |
401 |
$11K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
250 |
219 |
$6K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
302 |
258 |
$5K |
| 92082 |
|
104 |
77 |
$2K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
57 |
41 |
$2K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
163 |
136 |
$978.75 |
| 92310 |
|
13 |
13 |
$384.74 |
| 92015 |
Determination of refractive state |
43 |
39 |
$377.22 |
| V2760 |
Scratch resistant coating, per lens |
12 |
12 |
$24.00 |