| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
2,240 |
2,110 |
$90K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
302 |
282 |
$17K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
326 |
316 |
$14K |
| 92015 |
Determination of refractive state |
1,909 |
1,852 |
$7K |
| V2020 |
Frames, purchases |
520 |
481 |
$3K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
275 |
251 |
$150.00 |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
18 |
17 |
$92.18 |