| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
822 |
822 |
$89K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
1,574 |
1,572 |
$48K |
| 92015 |
Determination of refractive state |
2,363 |
2,360 |
$42K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
225 |
225 |
$29K |
| V2020 |
Frames, purchases |
1,361 |
1,358 |
$14K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
452 |
452 |
$12K |
| 92018 |
|
72 |
72 |
$1K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
1,636 |
1,635 |
$0.00 |