| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
380 |
377 |
$14K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
681 |
678 |
$10K |
| 92015 |
Determination of refractive state |
661 |
654 |
$4K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
77 |
77 |
$3K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
732 |
727 |
$0.00 |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
451 |
449 |
$0.00 |
| V2104 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, 2.12 to 4.00d cylinder, per lens |
12 |
12 |
$0.00 |
| V2020 |
Frames, purchases |
756 |
751 |
$0.00 |