| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
1,642 |
1,579 |
$119K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
719 |
695 |
$62K |
| 92015 |
Determination of refractive state |
2,747 |
2,673 |
$38K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
1,996 |
1,932 |
$37K |
| V2020 |
Frames, purchases |
15 |
15 |
$630.00 |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
15 |
15 |
$504.00 |