| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
568 |
508 |
$38K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
604 |
522 |
$15K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
51 |
46 |
$4K |
| V2020 |
Frames, purchases |
255 |
219 |
$3K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
30 |
16 |
$900.00 |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
37 |
34 |
$653.25 |
| 92015 |
Determination of refractive state |
318 |
284 |
$469.02 |