| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
798 |
771 |
$29K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
347 |
347 |
$15K |
| V2020 |
Frames, purchases |
953 |
936 |
$11K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
498 |
488 |
$11K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
205 |
201 |
$2K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
25 |
25 |
$499.71 |
| 92015 |
Determination of refractive state |
1,422 |
1,390 |
$333.28 |