| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
367 |
357 |
$14K |
| 92015 |
Determination of refractive state |
612 |
591 |
$11K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
316 |
307 |
$9K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
186 |
178 |
$8K |
| V2020 |
Frames, purchases |
59 |
58 |
$1K |
| 92341 |
|
38 |
38 |
$1K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
12 |
12 |
$161.00 |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
12 |
12 |
$60.00 |