| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
689 |
667 |
$34K |
| V2020 |
Frames, purchases |
982 |
971 |
$25K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
708 |
698 |
$11K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
114 |
112 |
$6K |
| 92015 |
Determination of refractive state |
253 |
251 |
$5K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
265 |
264 |
$4K |
| S0621 |
Routine ophthalmological examination including refraction; established patient |
48 |
48 |
$2K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
312 |
309 |
$1K |