| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
213 |
204 |
$12K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
414 |
396 |
$9K |
| 92015 |
Determination of refractive state |
424 |
409 |
$8K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
105 |
103 |
$7K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
73 |
73 |
$3K |
| V2020 |
Frames, purchases |
217 |
206 |
$3K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
133 |
124 |
$2K |