| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
193 |
188 |
$14K |
| V2020 |
Frames, purchases |
344 |
323 |
$7K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
276 |
265 |
$5K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
319 |
303 |
$2K |
| 92015 |
Determination of refractive state |
494 |
479 |
$1K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
30 |
27 |
$1K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
142 |
137 |
$345.00 |