| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
308 |
298 |
$14K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
368 |
357 |
$10K |
| 92015 |
Determination of refractive state |
463 |
438 |
$8K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
377 |
365 |
$7K |
| V2020 |
Frames, purchases |
356 |
348 |
$4K |
| V2025 |
Deluxe frame |
106 |
101 |
$4K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
328 |
325 |
$3K |
| V2200 |
Sphere, bifocal, plano to plus or minus 4.00d, per lens |
39 |
39 |
$1K |
| 92341 |
|
29 |
29 |
$846.74 |