| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
176 |
176 |
$9K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
421 |
421 |
$8K |
| 92015 |
Determination of refractive state |
582 |
581 |
$5K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
391 |
391 |
$5K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
94 |
94 |
$5K |
| V2020 |
Frames, purchases |
411 |
411 |
$4K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
412 |
412 |
$1K |