| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
539 |
537 |
$24K |
| 92015 |
Determination of refractive state |
1,202 |
1,194 |
$18K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
396 |
395 |
$17K |
| V2020 |
Frames, purchases |
358 |
353 |
$11K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
320 |
316 |
$9K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
219 |
218 |
$3K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
39 |
38 |
$838.14 |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
13 |
12 |
$153.12 |