| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
1,359 |
1,302 |
$90K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
1,045 |
1,007 |
$17K |
| 92015 |
Determination of refractive state |
1,544 |
1,489 |
$15K |
| V2020 |
Frames, purchases |
523 |
508 |
$11K |
| S0620 |
Routine ophthalmological examination including refraction; new patient |
202 |
202 |
$9K |
| 92341 |
|
431 |
424 |
$9K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
108 |
107 |
$2K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
235 |
229 |
$1K |
| 92250 |
|
16 |
16 |
$430.64 |
| V2203 |
Spherocylinder, bifocal, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
27 |
27 |
$365.77 |
| V2201 |
Sphere, bifocal, plus or minus 4.12 to plus or minus 7.00d, per lens |
36 |
29 |
$304.24 |