| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
360 |
340 |
$17K |
| 92015 |
Determination of refractive state |
460 |
436 |
$10K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
390 |
355 |
$7K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
223 |
125 |
$6K |
| V2020 |
Frames, purchases |
397 |
365 |
$5K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
218 |
200 |
$3K |