| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
29 |
23 |
$2K |
| V2020 |
Frames, purchases |
42 |
32 |
$1K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
32 |
24 |
$800.00 |
| 92015 |
Determination of refractive state |
37 |
28 |
$783.66 |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
23 |
18 |
$434.19 |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
41 |
31 |
$164.00 |