| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
431 |
427 |
$22K |
| V2020 |
Frames, purchases |
491 |
480 |
$10K |
| 92015 |
Determination of refractive state |
642 |
627 |
$3K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
862 |
425 |
$3K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
42 |
39 |
$2K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
403 |
239 |
$1K |