| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
574 |
566 |
$26K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
621 |
604 |
$26K |
| 92015 |
Determination of refractive state |
1,474 |
1,413 |
$25K |
| V2020 |
Frames, purchases |
879 |
830 |
$15K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
147 |
121 |
$4K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
285 |
247 |
$4K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
352 |
342 |
$4K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
106 |
97 |
$1K |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
14 |
13 |
$585.00 |