| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
191 |
184 |
$13K |
| 92015 |
Determination of refractive state |
326 |
317 |
$10K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
195 |
189 |
$9K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
139 |
137 |
$4K |
| V2020 |
Frames, purchases |
212 |
205 |
$2K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
43 |
41 |
$2K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
27 |
25 |
$429.96 |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
14 |
13 |
$19.40 |