| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
665 |
648 |
$79K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
284 |
271 |
$28K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
480 |
457 |
$15K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
1,000 |
952 |
$5K |
| 92015 |
Determination of refractive state |
931 |
907 |
$5K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
772 |
445 |
$5K |
| V2020 |
Frames, purchases |
956 |
917 |
$5K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
55 |
38 |
$288.50 |