| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
160 |
147 |
$8K |
| 92015 |
Determination of refractive state |
276 |
254 |
$7K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
241 |
154 |
$6K |
| V2020 |
Frames, purchases |
233 |
216 |
$4K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
226 |
212 |
$4K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
83 |
78 |
$3K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
191 |
102 |
$3K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
21 |
13 |
$508.00 |