| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
1,171 |
1,054 |
$51K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
498 |
428 |
$23K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
818 |
751 |
$21K |
| 92015 |
Determination of refractive state |
900 |
853 |
$15K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
192 |
169 |
$8K |
| V2020 |
Frames, purchases |
713 |
622 |
$7K |
| V2200 |
Sphere, bifocal, plano to plus or minus 4.00d, per lens |
33 |
24 |
$5K |
| 92341 |
|
108 |
96 |
$3K |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
12 |
12 |
$540.00 |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
126 |
101 |
$90.00 |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
94 |
76 |
$0.00 |