| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
2,128 |
2,104 |
$155K |
| V2020 |
Frames, purchases |
2,803 |
2,743 |
$88K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
756 |
753 |
$65K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
1,708 |
1,671 |
$53K |
| 92015 |
Determination of refractive state |
1,376 |
1,372 |
$26K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
669 |
668 |
$16K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
406 |
391 |
$12K |
| S0620 |
Routine ophthalmological examination including refraction; new patient |
106 |
106 |
$4K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
252 |
248 |
$2K |
| V2203 |
Spherocylinder, bifocal, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
52 |
51 |
$2K |