| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
445 |
408 |
$27K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
260 |
241 |
$21K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
266 |
252 |
$8K |
| V2020 |
Frames, purchases |
282 |
266 |
$7K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
101 |
94 |
$2K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
51 |
50 |
$401.00 |
| 92015 |
Determination of refractive state |
471 |
432 |
$220.00 |