| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
737 |
737 |
$45K |
| V2020 |
Frames, purchases |
861 |
856 |
$19K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
272 |
272 |
$17K |
| 92015 |
Determination of refractive state |
1,461 |
1,461 |
$16K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
844 |
839 |
$16K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
861 |
856 |
$7K |
| V2199 |
Not otherwise classified, single vision lens |
150 |
148 |
$6K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
345 |
344 |
$4K |