| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
617 |
615 |
$27K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
363 |
363 |
$16K |
| 92015 |
Determination of refractive state |
1,072 |
1,070 |
$15K |
| V2020 |
Frames, purchases |
365 |
364 |
$14K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
324 |
322 |
$9K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
262 |
262 |
$3K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
139 |
139 |
$2K |