| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
270 |
262 |
$18K |
| 92015 |
Determination of refractive state |
267 |
257 |
$10K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
183 |
178 |
$5K |
| V2020 |
Frames, purchases |
221 |
211 |
$3K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
73 |
64 |
$3K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
78 |
72 |
$2K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
132 |
93 |
$2K |
| V2783 |
Lens, index greater than or equal to 1.66 plastic or greater than or equal to 1.80 glass, excludes polycarbonate, per lens |
12 |
12 |
$440.00 |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
44 |
24 |
$363.64 |