| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
1,415 |
1,385 |
$121K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
1,121 |
1,090 |
$99K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
2,473 |
2,380 |
$7K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
1,756 |
1,690 |
$6K |
| V2020 |
Frames, purchases |
2,847 |
2,735 |
$3K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
127 |
120 |
$602.76 |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
325 |
314 |
$170.45 |
| 92015 |
Determination of refractive state |
2,756 |
2,688 |
$125.12 |
| 92341 |
|
49 |
47 |
$43.92 |
| V2203 |
Spherocylinder, bifocal, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
72 |
69 |
$42.83 |
| 92250 |
|
2,276 |
2,220 |
$0.00 |
| V2799 |
Vision item or service, miscellaneous |
16 |
16 |
$0.00 |
| 2023F |
|
25 |
24 |
$0.00 |
| 3072F |
|
12 |
12 |
$0.00 |