| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
542 |
531 |
$26K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
591 |
572 |
$25K |
| 92015 |
Determination of refractive state |
1,154 |
1,124 |
$17K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
654 |
637 |
$14K |
| V2020 |
Frames, purchases |
138 |
133 |
$3K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
80 |
78 |
$2K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
50 |
48 |
$598.00 |
| 92341 |
|
18 |
15 |
$403.55 |