| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
180 |
172 |
$15K |
| V2020 |
Frames, purchases |
415 |
401 |
$7K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
40 |
38 |
$4K |
| 92015 |
Determination of refractive state |
481 |
466 |
$1K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
342 |
329 |
$450.00 |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
51 |
50 |
$24.36 |