| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
1,115 |
1,077 |
$64K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
283 |
261 |
$18K |
| V2020 |
Frames, purchases |
228 |
223 |
$6K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
194 |
190 |
$6K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
130 |
113 |
$2K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
96 |
95 |
$435.50 |
| 92015 |
Determination of refractive state |
114 |
111 |
$161.76 |