| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
733 |
728 |
$33K |
| 92015 |
Determination of refractive state |
1,195 |
1,175 |
$19K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
563 |
563 |
$15K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
317 |
310 |
$14K |
| V2020 |
Frames, purchases |
137 |
137 |
$5K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
137 |
137 |
$2K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
134 |
134 |
$2K |