| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
316 |
316 |
$34K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
540 |
536 |
$16K |
| 92015 |
Determination of refractive state |
887 |
887 |
$16K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
87 |
87 |
$11K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
329 |
325 |
$9K |
| V2020 |
Frames, purchases |
583 |
579 |
$6K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
98 |
98 |
$3K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
618 |
614 |
$0.00 |