| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
460 |
453 |
$37K |
| V2020 |
Frames, purchases |
899 |
881 |
$21K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
67 |
67 |
$5K |
| 92015 |
Determination of refractive state |
868 |
859 |
$315.48 |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
884 |
866 |
$272.76 |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
243 |
238 |
$33.00 |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
13 |
13 |
$0.00 |