| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
333 |
327 |
$39K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
108 |
104 |
$10K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
434 |
417 |
$2K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
83 |
78 |
$2K |
| V2020 |
Frames, purchases |
374 |
360 |
$2K |
| 92015 |
Determination of refractive state |
219 |
215 |
$998.00 |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
97 |
51 |
$548.68 |