| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
691 |
624 |
$31K |
| V2020 |
Frames, purchases |
225 |
200 |
$4K |
| 92015 |
Determination of refractive state |
809 |
728 |
$4K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
97 |
73 |
$1K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
14 |
13 |
$663.75 |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
252 |
238 |
$629.91 |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
30 |
30 |
$618.40 |