| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
741 |
717 |
$50K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
517 |
503 |
$42K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
1,626 |
1,580 |
$28K |
| 92015 |
Determination of refractive state |
1,673 |
1,619 |
$14K |
| V2020 |
Frames, purchases |
63 |
63 |
$1K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
58 |
58 |
$1K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
53 |
53 |
$1.04 |