| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
1,611 |
1,611 |
$102K |
| 92015 |
Determination of refractive state |
2,427 |
2,427 |
$27K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
378 |
378 |
$22K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
550 |
545 |
$11K |
| V2020 |
Frames, purchases |
550 |
545 |
$9K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
372 |
368 |
$5K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
548 |
543 |
$3K |
| V2199 |
Not otherwise classified, single vision lens |
12 |
12 |
$636.00 |
| 3072F |
|
42 |
42 |
$420.00 |