| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
423 |
420 |
$36K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
205 |
202 |
$26K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
504 |
497 |
$23K |
| V2020 |
Frames, purchases |
586 |
586 |
$18K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
774 |
764 |
$13K |
| V2025 |
Deluxe frame |
172 |
171 |
$11K |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
100 |
99 |
$7K |
| 92015 |
Determination of refractive state |
891 |
885 |
$4K |