| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
574 |
563 |
$24K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
551 |
537 |
$23K |
| V2020 |
Frames, purchases |
391 |
358 |
$11K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
228 |
205 |
$6K |
| 92015 |
Determination of refractive state |
91 |
89 |
$2K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
101 |
87 |
$2K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
95 |
81 |
$539.00 |