| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
603 |
591 |
$71K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
373 |
360 |
$36K |
| V2020 |
Frames, purchases |
1,014 |
975 |
$28K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
891 |
856 |
$22K |
| 92015 |
Determination of refractive state |
1,620 |
1,576 |
$22K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
951 |
911 |
$15K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
289 |
280 |
$4K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
174 |
164 |
$3K |