| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
513 |
505 |
$22K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
458 |
442 |
$20K |
| V2020 |
Frames, purchases |
476 |
455 |
$15K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
257 |
252 |
$8K |
| 92015 |
Determination of refractive state |
190 |
178 |
$3K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
88 |
74 |
$1K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
84 |
70 |
$469.00 |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
27 |
17 |
$280.00 |