| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
548 |
347 |
$15K |
| V2020 |
Frames, purchases |
737 |
483 |
$13K |
| S0580 |
Polycarbonate lens (list this code in addition to the basic code for the lens) |
1,281 |
430 |
$11K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
344 |
264 |
$5K |
| 92015 |
Determination of refractive state |
191 |
149 |
$5K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
213 |
82 |
$2K |
| 92341 |
|
174 |
95 |
$2K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
37 |
27 |
$1K |
| V2201 |
Sphere, bifocal, plus or minus 4.12 to plus or minus 7.00d, per lens |
82 |
16 |
$613.80 |