| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
1,410 |
1,215 |
$67K |
| 92015 |
Determination of refractive state |
2,013 |
1,768 |
$33K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
935 |
792 |
$28K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
220 |
220 |
$10K |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
138 |
137 |
$6K |
| V2020 |
Frames, purchases |
262 |
262 |
$6K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
110 |
110 |
$2K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
106 |
106 |
$1K |