| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
850 |
850 |
$108K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
572 |
572 |
$59K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
1,119 |
1,116 |
$34K |
| 92015 |
Determination of refractive state |
1,139 |
1,138 |
$20K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
481 |
480 |
$12K |
| V2020 |
Frames, purchases |
1,121 |
1,118 |
$11K |
| V2101 |
Sphere, single vision, plus or minus 4.12 to plus or minus 7.00d, per lens |
286 |
286 |
$8K |
| 92250 |
|
56 |
56 |
$2K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
27 |
27 |
$641.70 |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
1,123 |
1,120 |
$0.00 |