| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
554 |
552 |
$38K |
| V2020 |
Frames, purchases |
695 |
690 |
$21K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
494 |
491 |
$15K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
123 |
120 |
$11K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
468 |
465 |
$4K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
206 |
204 |
$3K |
| 92015 |
Determination of refractive state |
902 |
889 |
$181.98 |