| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
250 |
146 |
$9K |
| 92015 |
Determination of refractive state |
335 |
259 |
$4K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
133 |
110 |
$4K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
140 |
69 |
$3K |
| V2020 |
Frames, purchases |
309 |
151 |
$3K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
179 |
81 |
$3K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
247 |
124 |
$3K |