| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
907 |
881 |
$60K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
298 |
287 |
$26K |
| V2020 |
Frames, purchases |
740 |
713 |
$22K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
495 |
483 |
$14K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
448 |
366 |
$7K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
548 |
526 |
$4K |
| 92250 |
|
14 |
14 |
$497.01 |
| 92341 |
|
13 |
12 |
$363.00 |
| 92015 |
Determination of refractive state |
976 |
931 |
$222.42 |