| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
845 |
817 |
$47K |
| V2020 |
Frames, purchases |
995 |
962 |
$34K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
97 |
91 |
$4K |
| 92015 |
Determination of refractive state |
1,030 |
1,002 |
$4K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
417 |
402 |
$3K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
398 |
371 |
$2K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
46 |
43 |
$146.16 |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
318 |
306 |
$70.34 |
| V2200 |
Sphere, bifocal, plano to plus or minus 4.00d, per lens |
29 |
28 |
$30.66 |
| 92341 |
|
15 |
14 |
$0.00 |