| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92015 |
Determination of refractive state |
519 |
495 |
$12K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
80 |
79 |
$4K |
| V2020 |
Frames, purchases |
278 |
268 |
$1K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
41 |
41 |
$1K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
12 |
12 |
$808.57 |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
63 |
63 |
$418.24 |