| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92015 |
Determination of refractive state |
343 |
340 |
$17K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
161 |
158 |
$16K |
| V2020 |
Frames, purchases |
452 |
446 |
$16K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
361 |
357 |
$5K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
16 |
16 |
$2K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
53 |
53 |
$2K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
72 |
67 |
$7.00 |