| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
353 |
298 |
$16K |
| 92015 |
Determination of refractive state |
501 |
487 |
$9K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
146 |
98 |
$8K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
165 |
149 |
$7K |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
67 |
55 |
$3K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
44 |
29 |
$2K |
| V2025 |
Deluxe frame |
111 |
80 |
$2K |
| V2020 |
Frames, purchases |
13 |
13 |
$459.80 |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
38 |
38 |
$222.72 |