| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
353 |
341 |
$13K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
431 |
418 |
$8K |
| V2020 |
Frames, purchases |
359 |
347 |
$5K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
188 |
99 |
$2K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
70 |
30 |
$825.00 |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
16 |
13 |
$706.05 |
| 92341 |
|
13 |
13 |
$296.67 |
| 92015 |
Determination of refractive state |
605 |
587 |
$121.18 |