| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
327 |
322 |
$28K |
| V2020 |
Frames, purchases |
308 |
295 |
$10K |
| 92015 |
Determination of refractive state |
769 |
752 |
$10K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
576 |
277 |
$9K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
339 |
324 |
$8K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
65 |
64 |
$6K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
18 |
12 |
$651.31 |