| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
1,426 |
1,426 |
$92K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
1,379 |
1,377 |
$83K |
| V2020 |
Frames, purchases |
1,787 |
1,778 |
$52K |
| V2199 |
Not otherwise classified, single vision lens |
850 |
846 |
$34K |
| 92015 |
Determination of refractive state |
3,030 |
3,028 |
$30K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
1,600 |
1,590 |
$29K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
1,787 |
1,778 |
$17K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
665 |
663 |
$9K |