| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
826 |
793 |
$73K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
490 |
475 |
$33K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
958 |
918 |
$13K |
| V2020 |
Frames, purchases |
1,005 |
963 |
$12K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
434 |
420 |
$7K |
| 92015 |
Determination of refractive state |
557 |
536 |
$6K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
147 |
144 |
$2K |
| 2026F |
|
219 |
216 |
$0.00 |
| 2033F |
|
110 |
104 |
$0.00 |