| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
603 |
539 |
$34K |
| 92015 |
Determination of refractive state |
1,110 |
1,003 |
$22K |
| V2020 |
Frames, purchases |
276 |
260 |
$8K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
292 |
280 |
$8K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
94 |
86 |
$2K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
265 |
249 |
$1K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
14 |
13 |
$1K |
| V2756 |
Eye glass case |
15 |
15 |
$7.80 |