| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
261 |
244 |
$21K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
94 |
92 |
$8K |
| V2020 |
Frames, purchases |
334 |
321 |
$1K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
308 |
301 |
$430.26 |
| 92015 |
Determination of refractive state |
536 |
521 |
$187.18 |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
84 |
80 |
$32.18 |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
36 |
35 |
$0.00 |