| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
336 |
304 |
$17K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
148 |
143 |
$11K |
| 92015 |
Determination of refractive state |
185 |
178 |
$5K |
| V2020 |
Frames, purchases |
470 |
446 |
$3K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
192 |
184 |
$3K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
503 |
314 |
$3K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
32 |
26 |
$944.82 |