| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
450 |
446 |
$20K |
| 92015 |
Determination of refractive state |
872 |
863 |
$15K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
287 |
283 |
$12K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
274 |
272 |
$8K |
| V2020 |
Frames, purchases |
25 |
25 |
$804.72 |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
12 |
12 |
$147.72 |