| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
1,119 |
1,055 |
$33K |
| V2020 |
Frames, purchases |
1,108 |
1,058 |
$19K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
790 |
764 |
$19K |
| 92015 |
Determination of refractive state |
1,504 |
1,413 |
$9K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
192 |
176 |
$8K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
711 |
696 |
$7K |
| V2200 |
Sphere, bifocal, plano to plus or minus 4.00d, per lens |
46 |
44 |
$2K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
147 |
139 |
$544.25 |
| T1015 |
Clinic visit/encounter, all-inclusive |
681 |
579 |
$0.00 |