| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
448 |
388 |
$19K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
211 |
188 |
$9K |
| V2020 |
Frames, purchases |
457 |
408 |
$8K |
| 92015 |
Determination of refractive state |
909 |
806 |
$4K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
550 |
531 |
$4K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
64 |
24 |
$705.18 |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
46 |
12 |
$256.91 |