| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
884 |
884 |
$91K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
685 |
685 |
$21K |
| 92015 |
Determination of refractive state |
948 |
948 |
$17K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
356 |
355 |
$10K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
69 |
69 |
$9K |
| V2020 |
Frames, purchases |
805 |
804 |
$8K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
65 |
65 |
$2K |