| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
930 |
895 |
$72K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
1,049 |
1,033 |
$67K |
| 92015 |
Determination of refractive state |
2,486 |
2,386 |
$11K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
1,675 |
1,662 |
$11K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
392 |
226 |
$6K |
| V2020 |
Frames, purchases |
328 |
274 |
$5K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
179 |
116 |
$2K |