| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
348 |
324 |
$32K |
| V2020 |
Frames, purchases |
431 |
404 |
$14K |
| 92015 |
Determination of refractive state |
586 |
549 |
$14K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
88 |
81 |
$10K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
361 |
341 |
$4K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
99 |
94 |
$3K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
60 |
53 |
$2K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
261 |
246 |
$21.00 |