| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
141 |
140 |
$15K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
401 |
392 |
$10K |
| V2020 |
Frames, purchases |
410 |
400 |
$9K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
93 |
93 |
$8K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
371 |
362 |
$6K |
| 92015 |
Determination of refractive state |
397 |
393 |
$6K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
143 |
137 |
$3K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
60 |
59 |
$1K |