| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
156 |
147 |
$15K |
| V2020 |
Frames, purchases |
488 |
420 |
$12K |
| 92015 |
Determination of refractive state |
602 |
520 |
$9K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
330 |
290 |
$5K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
107 |
90 |
$2K |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
12 |
12 |
$881.88 |