| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
633 |
633 |
$42K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
740 |
740 |
$27K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
263 |
263 |
$23K |
| V2020 |
Frames, purchases |
781 |
781 |
$20K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
728 |
725 |
$11K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
739 |
739 |
$9K |
| 92015 |
Determination of refractive state |
937 |
937 |
$6K |