| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
3,726 |
3,579 |
$316K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
897 |
870 |
$63K |
| V2020 |
Frames, purchases |
1,088 |
1,020 |
$22K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
529 |
493 |
$11K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
634 |
596 |
$7K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
324 |
296 |
$6K |
| V2203 |
Spherocylinder, bifocal, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
97 |
92 |
$5K |
| 92015 |
Determination of refractive state |
1,451 |
1,360 |
$3K |
| 92341 |
|
116 |
111 |
$1K |
| 3072F |
|
16 |
16 |
$40.00 |