| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
753 |
702 |
$35K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
405 |
382 |
$19K |
| 92015 |
Determination of refractive state |
1,260 |
1,177 |
$6K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
60 |
33 |
$1K |
| V2020 |
Frames, purchases |
59 |
46 |
$944.00 |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
57 |
57 |
$480.00 |