| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
554 |
392 |
$19K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
379 |
359 |
$16K |
| V2020 |
Frames, purchases |
601 |
409 |
$8K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
305 |
266 |
$7K |
| 92015 |
Determination of refractive state |
713 |
652 |
$3K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
550 |
411 |
$2K |