| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
622 |
604 |
$13K |
| 92015 |
Determination of refractive state |
608 |
598 |
$12K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
237 |
231 |
$10K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
172 |
169 |
$8K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
421 |
411 |
$0.00 |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
624 |
606 |
$0.00 |
| V2020 |
Frames, purchases |
623 |
605 |
$0.00 |