| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
315 |
315 |
$33K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
1,033 |
1,030 |
$31K |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
385 |
385 |
$30K |
| 92015 |
Determination of refractive state |
1,246 |
1,246 |
$22K |
| V2020 |
Frames, purchases |
1,040 |
1,036 |
$10K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
378 |
378 |
$9K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
206 |
205 |
$5K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
29 |
29 |
$4K |
| 92002 |
|
24 |
24 |
$2K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
852 |
850 |
$0.00 |