| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
648 |
601 |
$29K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
464 |
425 |
$20K |
| 92015 |
Determination of refractive state |
1,175 |
1,089 |
$5K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
612 |
606 |
$4K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
223 |
93 |
$2K |
| V2020 |
Frames, purchases |
119 |
96 |
$1K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
59 |
30 |
$375.36 |