| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
236 |
231 |
$21K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
150 |
148 |
$8K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
61 |
58 |
$6K |
| 92015 |
Determination of refractive state |
407 |
395 |
$5K |
| V2020 |
Frames, purchases |
149 |
147 |
$5K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
131 |
128 |
$3K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
13 |
13 |
$570.00 |