| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
1,023 |
1,011 |
$89K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
503 |
502 |
$39K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
1,608 |
1,601 |
$32K |
| 92015 |
Determination of refractive state |
1,781 |
1,766 |
$22K |
| V2020 |
Frames, purchases |
1,157 |
1,147 |
$12K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
572 |
500 |
$7K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
589 |
380 |
$4K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
1,188 |
1,179 |
$4K |
| 92310 |
|
13 |
13 |
$700.18 |