| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
483 |
472 |
$25K |
| 92015 |
Determination of refractive state |
754 |
729 |
$13K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
392 |
366 |
$11K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
170 |
162 |
$8K |
| V2020 |
Frames, purchases |
295 |
274 |
$5K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
203 |
191 |
$2K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
175 |
163 |
$2K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
75 |
69 |
$736.59 |