| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
4,135 |
4,116 |
$181K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
2,508 |
2,502 |
$112K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
5,687 |
3,043 |
$111K |
| V2020 |
Frames, purchases |
2,331 |
2,325 |
$32K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
5,235 |
2,724 |
$4K |
| 92015 |
Determination of refractive state |
119 |
119 |
$2K |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
43 |
42 |
$2K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
28 |
14 |
$451.88 |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
12 |
12 |
$430.20 |