| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
624 |
598 |
$41K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
229 |
225 |
$9K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
87 |
82 |
$8K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
245 |
233 |
$7K |
| V2020 |
Frames, purchases |
272 |
251 |
$6K |
| 92015 |
Determination of refractive state |
448 |
421 |
$1K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
17 |
17 |
$243.40 |