| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
749 |
744 |
$34K |
| 92015 |
Determination of refractive state |
1,378 |
1,368 |
$21K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
457 |
455 |
$20K |
| V2020 |
Frames, purchases |
428 |
427 |
$16K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
511 |
508 |
$15K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
343 |
342 |
$4K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
96 |
96 |
$1K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
44 |
44 |
$558.40 |