| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| V2020 |
Frames, purchases |
261 |
247 |
$9K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
208 |
200 |
$8K |
| 92015 |
Determination of refractive state |
505 |
494 |
$5K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
116 |
115 |
$5K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
177 |
177 |
$4K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
239 |
227 |
$4K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
205 |
193 |
$2K |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
14 |
14 |
$630.00 |