| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
1,578 |
1,476 |
$79K |
| V2020 |
Frames, purchases |
766 |
710 |
$17K |
| 92015 |
Determination of refractive state |
1,832 |
1,732 |
$9K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
578 |
558 |
$4K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
42 |
27 |
$911.27 |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
58 |
26 |
$587.48 |