| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
220 |
208 |
$23K |
| V2020 |
Frames, purchases |
441 |
408 |
$13K |
| 92015 |
Determination of refractive state |
571 |
538 |
$8K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
228 |
218 |
$8K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
426 |
393 |
$7K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
40 |
38 |
$4K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
13 |
13 |
$127.68 |