| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
459 |
426 |
$29K |
| V2020 |
Frames, purchases |
446 |
423 |
$14K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
128 |
122 |
$13K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
494 |
467 |
$11K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
339 |
318 |
$11K |
| 92015 |
Determination of refractive state |
754 |
693 |
$8K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
12 |
12 |
$106.40 |