| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
218 |
218 |
$20K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
549 |
541 |
$16K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
112 |
112 |
$13K |
| 92015 |
Determination of refractive state |
708 |
708 |
$12K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
311 |
306 |
$9K |
| V2108 |
Spherocylinder, single vision, plus or minus 4.25d to plus or minus 7.00d sphere, 2.12 to 4.00d cylinder, per lens |
249 |
242 |
$7K |
| V2020 |
Frames, purchases |
561 |
555 |
$6K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
641 |
625 |
$0.00 |