| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
565 |
536 |
$33K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
203 |
170 |
$15K |
| 92015 |
Determination of refractive state |
805 |
743 |
$3K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
252 |
200 |
$2K |
| V2020 |
Frames, purchases |
354 |
286 |
$948.70 |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
368 |
300 |
$720.00 |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
206 |
170 |
$130.00 |