| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
669 |
657 |
$44K |
| 92015 |
Determination of refractive state |
766 |
740 |
$27K |
| V2020 |
Frames, purchases |
663 |
635 |
$19K |
| S0580 |
Polycarbonate lens (list this code in addition to the basic code for the lens) |
613 |
587 |
$17K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
489 |
475 |
$17K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
597 |
578 |
$13K |