| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
589 |
569 |
$47K |
| V2020 |
Frames, purchases |
700 |
651 |
$23K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
783 |
367 |
$17K |
| 92015 |
Determination of refractive state |
1,400 |
1,336 |
$17K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
144 |
70 |
$4K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
41 |
40 |
$4K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
143 |
123 |
$2K |
| 92370 |
|
42 |
41 |
$825.12 |