| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
231 |
219 |
$27K |
| 92015 |
Determination of refractive state |
635 |
541 |
$13K |
| V2020 |
Frames, purchases |
294 |
271 |
$9K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
259 |
237 |
$5K |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
33 |
31 |
$2K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
45 |
45 |
$2K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
59 |
52 |
$1K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
57 |
52 |
$56.15 |