| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
573 |
537 |
$46K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
324 |
313 |
$32K |
| V2020 |
Frames, purchases |
210 |
205 |
$7K |
| 92015 |
Determination of refractive state |
469 |
452 |
$7K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
158 |
155 |
$6K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
167 |
163 |
$4K |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
29 |
28 |
$2K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
51 |
50 |
$760.00 |