| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
230 |
225 |
$17K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
197 |
187 |
$16K |
| V2020 |
Frames, purchases |
622 |
576 |
$9K |
| 92015 |
Determination of refractive state |
755 |
736 |
$2K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
482 |
443 |
$1K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
81 |
79 |
$200.52 |