| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
468 |
436 |
$51K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
361 |
322 |
$31K |
| V2020 |
Frames, purchases |
111 |
98 |
$4K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
33 |
30 |
$2K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
196 |
85 |
$2K |
| 92015 |
Determination of refractive state |
1,213 |
1,112 |
$1K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
55 |
48 |
$1K |
| V2750 |
Anti-reflective coating, per lens |
70 |
32 |
$827.20 |