| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
198 |
198 |
$9K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
164 |
164 |
$7K |
| V2020 |
Frames, purchases |
432 |
428 |
$6K |
| 92015 |
Determination of refractive state |
692 |
687 |
$5K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
211 |
211 |
$5K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
122 |
120 |
$3K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
281 |
276 |
$1K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
13 |
12 |
$0.00 |