| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
1,396 |
1,390 |
$136K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
1,366 |
1,353 |
$126K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
4,236 |
4,195 |
$103K |
| V2020 |
Frames, purchases |
3,291 |
3,262 |
$75K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
1,441 |
1,425 |
$58K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
1,744 |
1,727 |
$35K |
| V2025 |
Deluxe frame |
687 |
685 |
$29K |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
339 |
339 |
$25K |
| 92015 |
Determination of refractive state |
2,815 |
2,800 |
$15K |
| V2104 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, 2.12 to 4.00d cylinder, per lens |
56 |
56 |
$674.88 |