| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
1,543 |
1,443 |
$58K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
1,490 |
1,443 |
$56K |
| V2020 |
Frames, purchases |
1,836 |
1,791 |
$24K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
1,000 |
974 |
$19K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
872 |
838 |
$18K |
| 92015 |
Determination of refractive state |
3,038 |
2,904 |
$15K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
1,121 |
1,090 |
$6K |
| 92310 |
|
25 |
25 |
$1K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
91 |
88 |
$1K |
| 92341 |
|
40 |
40 |
$973.55 |
| 3072F |
|
12 |
12 |
$0.00 |