| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
552 |
539 |
$20K |
| V2020 |
Frames, purchases |
1,320 |
1,242 |
$16K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
653 |
614 |
$13K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
766 |
712 |
$6K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
144 |
142 |
$5K |
| 92015 |
Determination of refractive state |
1,110 |
1,091 |
$2K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
26 |
24 |
$433.68 |