| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
2,348 |
2,173 |
$120K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
656 |
613 |
$31K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
144 |
138 |
$3K |
| V2020 |
Frames, purchases |
259 |
223 |
$3K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
219 |
202 |
$3K |
| 92015 |
Determination of refractive state |
71 |
64 |
$310.00 |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
18 |
18 |
$208.00 |