| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
127 |
126 |
$14K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
136 |
136 |
$13K |
| V2782 |
Lens, index 1.54 to 1.65 plastic or 1.60 to 1.79 glass, excludes polycarbonate, per lens |
198 |
195 |
$10K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
220 |
203 |
$5K |
| V2020 |
Frames, purchases |
203 |
199 |
$4K |
| 92015 |
Determination of refractive state |
293 |
292 |
$4K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
209 |
205 |
$4K |