| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
6,137 |
5,672 |
$278K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
4,252 |
3,883 |
$192K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
6,455 |
5,829 |
$192K |
| 92015 |
Determination of refractive state |
7,844 |
7,118 |
$141K |
| V2020 |
Frames, purchases |
1,190 |
1,129 |
$16K |
| 92250 |
|
303 |
256 |
$13K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
564 |
542 |
$7K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
702 |
688 |
$4K |
| 92341 |
|
72 |
66 |
$2K |
| V2104 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, 2.12 to 4.00d cylinder, per lens |
29 |
29 |
$392.00 |
| V2025 |
Deluxe frame |
33 |
32 |
$330.00 |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
16 |
16 |
$201.50 |
| 3072F |
|
65 |
65 |
$0.00 |