| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
309 |
252 |
$22K |
| 92015 |
Determination of refractive state |
753 |
655 |
$14K |
| V2020 |
Frames, purchases |
408 |
315 |
$8K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
470 |
377 |
$7K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
30 |
25 |
$837.27 |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
62 |
37 |
$623.84 |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
27 |
26 |
$493.24 |