| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
1,011 |
1,006 |
$46K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
1,035 |
1,024 |
$45K |
| 92015 |
Determination of refractive state |
2,157 |
2,139 |
$34K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
855 |
829 |
$24K |
| V2020 |
Frames, purchases |
657 |
644 |
$17K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
318 |
304 |
$8K |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
143 |
120 |
$6K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
203 |
203 |
$2K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
110 |
110 |
$1K |
| V2025 |
Deluxe frame |
14 |
14 |
$151.20 |