| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
351 |
351 |
$37K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
745 |
743 |
$22K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
590 |
587 |
$16K |
| 92015 |
Determination of refractive state |
665 |
665 |
$12K |
| V2020 |
Frames, purchases |
751 |
749 |
$7K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
24 |
24 |
$3K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
820 |
817 |
$0.00 |