| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
275 |
267 |
$29K |
| V2020 |
Frames, purchases |
357 |
345 |
$26K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
295 |
165 |
$10K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
70 |
70 |
$9K |
| 92015 |
Determination of refractive state |
437 |
416 |
$7K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
149 |
132 |
$5K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
165 |
157 |
$5K |