| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
469 |
469 |
$36K |
| V2020 |
Frames, purchases |
672 |
669 |
$22K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
388 |
386 |
$8K |
| 92015 |
Determination of refractive state |
606 |
604 |
$7K |
| 92341 |
|
91 |
91 |
$2K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
171 |
170 |
$2K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
24 |
24 |
$1K |
| V2203 |
Spherocylinder, bifocal, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
74 |
74 |
$1K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
49 |
49 |
$638.82 |