| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
124 |
120 |
$5K |
| 92015 |
Determination of refractive state |
392 |
387 |
$3K |
| 92065 |
|
98 |
53 |
$3K |
| V2020 |
Frames, purchases |
320 |
314 |
$3K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
304 |
299 |
$2K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
12 |
12 |
$611.38 |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
26 |
26 |
$377.20 |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
14 |
14 |
$260.64 |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
13 |
13 |
$208.00 |