| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
849 |
830 |
$36K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
305 |
297 |
$16K |
| V2020 |
Frames, purchases |
151 |
129 |
$4K |
| 92015 |
Determination of refractive state |
857 |
853 |
$4K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
388 |
387 |
$4K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
23 |
16 |
$590.84 |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
27 |
16 |
$78.00 |