| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
278 |
268 |
$18K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
100 |
90 |
$7K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
438 |
385 |
$7K |
| 92015 |
Determination of refractive state |
967 |
906 |
$4K |
| V2020 |
Frames, purchases |
500 |
445 |
$3K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
402 |
373 |
$715.26 |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
261 |
220 |
$582.84 |