| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
524 |
518 |
$23K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
391 |
387 |
$17K |
| V2020 |
Frames, purchases |
786 |
777 |
$14K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
527 |
522 |
$13K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
175 |
169 |
$4K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
265 |
263 |
$3K |
| 92015 |
Determination of refractive state |
950 |
943 |
$0.00 |