| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
158 |
158 |
$13K |
| 92015 |
Determination of refractive state |
425 |
425 |
$8K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
374 |
373 |
$7K |
| V2020 |
Frames, purchases |
502 |
501 |
$6K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
504 |
503 |
$2K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
95 |
95 |
$1K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
14 |
14 |
$184.00 |