| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
423 |
358 |
$18K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
196 |
159 |
$8K |
| 92015 |
Determination of refractive state |
768 |
648 |
$3K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
313 |
299 |
$3K |
| V2020 |
Frames, purchases |
140 |
100 |
$2K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
122 |
84 |
$1K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
154 |
66 |
$1K |