| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
179 |
176 |
$17K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
130 |
125 |
$12K |
| V2020 |
Frames, purchases |
307 |
276 |
$7K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
57 |
39 |
$1K |
| 92015 |
Determination of refractive state |
596 |
579 |
$317.50 |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
159 |
141 |
$0.00 |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
26 |
13 |
$0.00 |