| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
211 |
211 |
$13K |
| 92015 |
Determination of refractive state |
555 |
553 |
$11K |
| V2020 |
Frames, purchases |
345 |
320 |
$10K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
109 |
109 |
$8K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
243 |
223 |
$6K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
276 |
253 |
$2K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
87 |
78 |
$1K |
| V2782 |
Lens, index 1.54 to 1.65 plastic or 1.60 to 1.79 glass, excludes polycarbonate, per lens |
33 |
33 |
$1K |