| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
1,113 |
1,053 |
$72K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
822 |
770 |
$47K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
151 |
143 |
$13K |
| 92015 |
Determination of refractive state |
1,394 |
1,297 |
$2K |
| V2020 |
Frames, purchases |
45 |
41 |
$918.75 |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
15 |
14 |
$352.80 |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
14 |
14 |
$78.00 |