| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
1,189 |
1,166 |
$105K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
1,128 |
1,114 |
$79K |
| V2020 |
Frames, purchases |
1,651 |
1,583 |
$66K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
1,223 |
768 |
$34K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
1,548 |
944 |
$27K |
| 92015 |
Determination of refractive state |
2,759 |
2,676 |
$14K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
387 |
386 |
$3K |
| 92250 |
|
12 |
12 |
$137.95 |