| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
80 |
76 |
$6K |
| V2782 |
Lens, index 1.54 to 1.65 plastic or 1.60 to 1.79 glass, excludes polycarbonate, per lens |
27 |
24 |
$2K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
42 |
39 |
$471.80 |
| 92015 |
Determination of refractive state |
150 |
146 |
$354.23 |
| V2020 |
Frames, purchases |
88 |
83 |
$235.90 |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
81 |
77 |
$0.00 |