| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
380 |
355 |
$21K |
| V2020 |
Frames, purchases |
657 |
599 |
$17K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
120 |
119 |
$7K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
490 |
442 |
$2K |
| 92015 |
Determination of refractive state |
827 |
739 |
$2K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
458 |
412 |
$796.34 |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
13 |
12 |
$0.00 |