| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
350 |
350 |
$37K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
757 |
746 |
$23K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
783 |
764 |
$22K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
153 |
153 |
$19K |
| 92015 |
Determination of refractive state |
643 |
634 |
$11K |
| V2020 |
Frames, purchases |
755 |
744 |
$8K |