| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
249 |
197 |
$18K |
| 92015 |
Determination of refractive state |
504 |
384 |
$9K |
| V2020 |
Frames, purchases |
323 |
220 |
$6K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
221 |
138 |
$1K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
102 |
41 |
$374.44 |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
27 |
27 |
$0.00 |