| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
528 |
486 |
$38K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
309 |
280 |
$25K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
826 |
741 |
$21K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
463 |
403 |
$14K |
| V2020 |
Frames, purchases |
523 |
460 |
$6K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
143 |
124 |
$2K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
120 |
115 |
$2K |
| 92015 |
Determination of refractive state |
327 |
296 |
$429.41 |