| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
221 |
214 |
$18K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
145 |
144 |
$7K |
| V2020 |
Frames, purchases |
405 |
389 |
$6K |
| 92015 |
Determination of refractive state |
499 |
483 |
$3K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
407 |
390 |
$3K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
183 |
174 |
$910.41 |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
12 |
12 |
$152.25 |