| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
677 |
604 |
$30K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
136 |
122 |
$6K |
| 92015 |
Determination of refractive state |
906 |
816 |
$4K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
469 |
453 |
$4K |
| V2020 |
Frames, purchases |
171 |
122 |
$2K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
116 |
58 |
$2K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
50 |
13 |
$279.25 |