| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
2,149 |
2,125 |
$100K |
| 92015 |
Determination of refractive state |
3,323 |
3,288 |
$56K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
1,683 |
1,664 |
$50K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
1,069 |
1,066 |
$47K |
| V2020 |
Frames, purchases |
1,254 |
1,226 |
$27K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
709 |
694 |
$12K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
882 |
861 |
$9K |
| V2200 |
Sphere, bifocal, plano to plus or minus 4.00d, per lens |
27 |
27 |
$638.22 |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
31 |
26 |
$332.00 |