| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
1,060 |
1,057 |
$87K |
| V2020 |
Frames, purchases |
2,484 |
2,467 |
$74K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
941 |
936 |
$65K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
1,918 |
1,903 |
$37K |
| 92015 |
Determination of refractive state |
2,151 |
2,138 |
$23K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
1,282 |
1,270 |
$21K |
| 92341 |
|
266 |
264 |
$6K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
66 |
65 |
$599.78 |
| 92250 |
|
24 |
24 |
$466.01 |
| V2104 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, 2.12 to 4.00d cylinder, per lens |
14 |
14 |
$179.26 |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
677 |
675 |
$0.00 |