| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
701 |
701 |
$43K |
| 92015 |
Determination of refractive state |
1,205 |
1,205 |
$19K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
823 |
822 |
$16K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
597 |
596 |
$8K |
| V2020 |
Frames, purchases |
825 |
824 |
$8K |
| V2760 |
Scratch resistant coating, per lens |
836 |
836 |
$8K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
837 |
837 |
$2K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
26 |
26 |
$364.00 |