| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
212 |
207 |
$12K |
| V2020 |
Frames, purchases |
477 |
436 |
$11K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
480 |
439 |
$8K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
95 |
93 |
$7K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
952 |
441 |
$7K |
| 92015 |
Determination of refractive state |
472 |
460 |
$4K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
193 |
187 |
$3.70 |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
164 |
140 |
$3.05 |