| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
500 |
484 |
$43K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
400 |
383 |
$35K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
1,219 |
1,147 |
$4K |
| V2020 |
Frames, purchases |
1,320 |
1,241 |
$3K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
355 |
335 |
$1K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
478 |
452 |
$930.07 |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
138 |
130 |
$853.53 |
| 92015 |
Determination of refractive state |
1,199 |
1,156 |
$90.00 |
| 92250 |
|
374 |
358 |
$0.00 |