| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
572 |
563 |
$48K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
429 |
417 |
$42K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
753 |
742 |
$28K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
628 |
627 |
$19K |
| 92015 |
Determination of refractive state |
571 |
561 |
$9K |
| V2020 |
Frames, purchases |
713 |
712 |
$8K |
| 92250 |
|
76 |
76 |
$3K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
173 |
173 |
$3K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
82 |
81 |
$1K |