| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92015 |
Determination of refractive state |
4,782 |
4,714 |
$127K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
5,284 |
5,149 |
$122K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
1,288 |
1,266 |
$79K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
1,498 |
1,468 |
$76K |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
1,272 |
1,259 |
$53K |
| V2020 |
Frames, purchases |
2,995 |
2,893 |
$16K |
| 92002 |
|
230 |
230 |
$11K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
1,679 |
1,621 |
$8K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
212 |
203 |
$994.96 |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
1,108 |
1,088 |
$246.00 |
| V2104 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, 2.12 to 4.00d cylinder, per lens |
12 |
12 |
$119.56 |
| 2022F |
|
612 |
610 |
$0.00 |
| 2023F |
|
331 |
322 |
$0.00 |
| 3072F |
|
175 |
175 |
$0.00 |