| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
405 |
393 |
$40K |
| V2020 |
Frames, purchases |
620 |
604 |
$21K |
| 92015 |
Determination of refractive state |
675 |
658 |
$18K |
| V2104 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, 2.12 to 4.00d cylinder, per lens |
466 |
453 |
$15K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
565 |
549 |
$9K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
31 |
31 |
$4K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
40 |
40 |
$1K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
205 |
195 |
$0.00 |