| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
767 |
755 |
$31K |
| 92015 |
Determination of refractive state |
610 |
606 |
$6K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
275 |
146 |
$5K |
| V2020 |
Frames, purchases |
420 |
417 |
$4K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
42 |
42 |
$2K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
50 |
50 |
$735.00 |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
143 |
80 |
$186.00 |