| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
799 |
767 |
$36K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
334 |
314 |
$16K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
425 |
406 |
$9K |
| V2020 |
Frames, purchases |
261 |
259 |
$4K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
120 |
119 |
$3K |
| 92015 |
Determination of refractive state |
59 |
59 |
$675.00 |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
26 |
26 |
$384.00 |
| 92341 |
|
12 |
12 |
$320.64 |