| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
467 |
466 |
$18K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
1,216 |
1,203 |
$17K |
| 92015 |
Determination of refractive state |
780 |
774 |
$5K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
103 |
103 |
$4K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
1,252 |
1,229 |
$10.00 |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
766 |
761 |
$0.00 |
| V2020 |
Frames, purchases |
1,375 |
1,350 |
$0.00 |