| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
470 |
362 |
$28K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
305 |
243 |
$17K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
761 |
618 |
$11K |
| 92015 |
Determination of refractive state |
1,371 |
1,142 |
$9K |
| V2020 |
Frames, purchases |
349 |
343 |
$5K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
178 |
168 |
$3K |
| V2745 |
Addition to lens; tint, any color, solid, gradient or equal, excludes photochromatic, any lens material, per lens |
42 |
41 |
$2K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
159 |
157 |
$2K |