| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
922 |
882 |
$60K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
508 |
495 |
$45K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
515 |
489 |
$25K |
| 92015 |
Determination of refractive state |
1,445 |
1,376 |
$18K |
| V2020 |
Frames, purchases |
611 |
422 |
$4K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
155 |
98 |
$790.50 |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
92 |
69 |
$697.30 |