| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
320 |
320 |
$30K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
313 |
311 |
$9K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
272 |
271 |
$8K |
| 92015 |
Determination of refractive state |
367 |
367 |
$6K |
| V2020 |
Frames, purchases |
286 |
285 |
$3K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
273 |
272 |
$0.00 |