| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
304 |
301 |
$13K |
| 92015 |
Determination of refractive state |
540 |
534 |
$11K |
| V2020 |
Frames, purchases |
360 |
354 |
$6K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
288 |
282 |
$5K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
55 |
53 |
$3K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
75 |
72 |
$3K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
95 |
94 |
$1K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
13 |
12 |
$497.66 |