| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
657 |
639 |
$43K |
| 92015 |
Determination of refractive state |
952 |
928 |
$35K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
1,143 |
1,109 |
$34K |
| V2020 |
Frames, purchases |
1,198 |
1,164 |
$34K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
1,385 |
1,342 |
$29K |
| S0580 |
Polycarbonate lens (list this code in addition to the basic code for the lens) |
467 |
458 |
$13K |
| 92250 |
|
275 |
268 |
$11K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
81 |
80 |
$4K |
| 92225 |
|
86 |
84 |
$1K |