| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
216 |
216 |
$23K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
515 |
513 |
$15K |
| 92015 |
Determination of refractive state |
757 |
756 |
$13K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
428 |
426 |
$12K |
| V2020 |
Frames, purchases |
542 |
540 |
$5K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
16 |
16 |
$2K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
571 |
569 |
$0.00 |