| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
100 |
100 |
$9K |
| V2020 |
Frames, purchases |
115 |
115 |
$4K |
| 92015 |
Determination of refractive state |
184 |
183 |
$3K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
81 |
81 |
$2K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
51 |
28 |
$1K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
13 |
13 |
$325.60 |