| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
949 |
933 |
$61K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
542 |
539 |
$43K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
1,632 |
1,609 |
$37K |
| 92015 |
Determination of refractive state |
1,543 |
1,521 |
$28K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
197 |
191 |
$5K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
149 |
145 |
$5K |
| V2020 |
Frames, purchases |
329 |
320 |
$2K |
| V2756 |
Eye glass case |
308 |
299 |
$353.01 |