| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
288 |
288 |
$9K |
| 92015 |
Determination of refractive state |
420 |
420 |
$7K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
69 |
69 |
$7K |
| V2020 |
Frames, purchases |
311 |
311 |
$3K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
112 |
112 |
$3K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
13 |
13 |
$2K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
289 |
289 |
$0.00 |