| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
451 |
446 |
$17K |
| V2020 |
Frames, purchases |
580 |
565 |
$9K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
411 |
403 |
$8K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
98 |
98 |
$4K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
172 |
164 |
$1K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
106 |
89 |
$805.49 |
| 92015 |
Determination of refractive state |
742 |
728 |
$541.58 |