| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
106 |
77 |
$6K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
252 |
247 |
$6K |
| 92015 |
Determination of refractive state |
446 |
398 |
$5K |
| V2020 |
Frames, purchases |
187 |
177 |
$4K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
187 |
178 |
$3K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
167 |
157 |
$3K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
18 |
12 |
$90.22 |