| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
453 |
453 |
$30K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
522 |
517 |
$19K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
205 |
203 |
$17K |
| V2020 |
Frames, purchases |
538 |
533 |
$14K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
459 |
457 |
$8K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
506 |
504 |
$6K |
| 92015 |
Determination of refractive state |
725 |
723 |
$5K |