| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
192 |
171 |
$14K |
| 92015 |
Determination of refractive state |
394 |
348 |
$8K |
| V2020 |
Frames, purchases |
253 |
220 |
$8K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
127 |
113 |
$7K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
133 |
114 |
$2K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
56 |
47 |
$1K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
249 |
218 |
$996.00 |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
64 |
51 |
$580.00 |