| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
436 |
407 |
$25K |
| 92015 |
Determination of refractive state |
913 |
856 |
$19K |
| V2020 |
Frames, purchases |
495 |
451 |
$11K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
243 |
218 |
$6K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
61 |
58 |
$4K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
569 |
522 |
$3K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
55 |
51 |
$833.94 |
| V2756 |
Eye glass case |
12 |
12 |
$6.24 |