| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
422 |
404 |
$23K |
| V2020 |
Frames, purchases |
581 |
524 |
$15K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
165 |
159 |
$9K |
| 92015 |
Determination of refractive state |
684 |
656 |
$4K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
499 |
450 |
$3K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
508 |
459 |
$3K |