| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
1,555 |
1,547 |
$75K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
1,659 |
1,651 |
$30K |
| 92015 |
Determination of refractive state |
2,294 |
2,285 |
$30K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
324 |
323 |
$20K |
| V2020 |
Frames, purchases |
634 |
629 |
$11K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
501 |
454 |
$3K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
109 |
101 |
$1K |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
12 |
12 |
$446.72 |