| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
895 |
868 |
$42K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
1,036 |
1,020 |
$21K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
390 |
387 |
$20K |
| 92015 |
Determination of refractive state |
1,143 |
1,087 |
$12K |
| V2020 |
Frames, purchases |
29 |
29 |
$985.00 |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
26 |
26 |
$888.38 |
| 92341 |
|
27 |
27 |
$685.25 |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
24 |
24 |
$184.50 |