| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
39 |
39 |
$6K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
54 |
53 |
$3K |
| V2020 |
Frames, purchases |
33 |
33 |
$3K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
78 |
77 |
$3K |
| 92015 |
Determination of refractive state |
104 |
103 |
$2K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
12 |
12 |
$2K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
15 |
15 |
$1K |