| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
684 |
674 |
$28K |
| 92015 |
Determination of refractive state |
1,079 |
1,062 |
$11K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
223 |
221 |
$10K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
458 |
449 |
$10K |
| V2020 |
Frames, purchases |
214 |
214 |
$4K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
135 |
135 |
$3K |
| 92341 |
|
115 |
113 |
$3K |
| V2200 |
Sphere, bifocal, plano to plus or minus 4.00d, per lens |
12 |
12 |
$452.40 |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
19 |
19 |
$247.00 |