| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
1,102 |
1,102 |
$120K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
613 |
610 |
$19K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
627 |
626 |
$17K |
| 92015 |
Determination of refractive state |
898 |
891 |
$16K |
| V2020 |
Frames, purchases |
816 |
812 |
$8K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
25 |
25 |
$3K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
38 |
38 |
$1K |