| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
406 |
401 |
$18K |
| 92015 |
Determination of refractive state |
1,053 |
1,030 |
$16K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
373 |
363 |
$16K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
337 |
333 |
$10K |
| V2020 |
Frames, purchases |
141 |
139 |
$5K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
120 |
119 |
$1K |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
14 |
14 |
$630.00 |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
22 |
22 |
$236.06 |