| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
203 |
198 |
$20K |
| 92015 |
Determination of refractive state |
562 |
540 |
$17K |
| V2020 |
Frames, purchases |
467 |
448 |
$16K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
394 |
379 |
$6K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
135 |
130 |
$3K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
14 |
14 |
$2K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
28 |
28 |
$860.56 |