| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
273 |
209 |
$18K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
173 |
110 |
$6K |
| V2020 |
Frames, purchases |
347 |
180 |
$6K |
| 92015 |
Determination of refractive state |
422 |
322 |
$4K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
192 |
164 |
$4K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
70 |
66 |
$3K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
18 |
17 |
$2K |