| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
120 |
114 |
$9K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
97 |
88 |
$8K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
127 |
116 |
$1K |
| 92015 |
Determination of refractive state |
357 |
338 |
$371.60 |
| V2020 |
Frames, purchases |
315 |
290 |
$322.05 |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
255 |
240 |
$84.71 |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
168 |
152 |
$15.12 |