| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
327 |
293 |
$20K |
| V2020 |
Frames, purchases |
411 |
387 |
$8K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
128 |
115 |
$6K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
100 |
87 |
$1K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
394 |
364 |
$667.32 |
| 92015 |
Determination of refractive state |
401 |
385 |
$135.00 |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
100 |
95 |
$0.00 |