| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
461 |
457 |
$20K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
402 |
398 |
$18K |
| 92015 |
Determination of refractive state |
915 |
902 |
$17K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
498 |
494 |
$15K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
456 |
432 |
$6K |
| V2020 |
Frames, purchases |
410 |
378 |
$5K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
359 |
342 |
$5K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
39 |
38 |
$479.71 |