| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
493 |
482 |
$11K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
153 |
151 |
$7K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
67 |
67 |
$3K |
| 92015 |
Determination of refractive state |
27 |
27 |
$562.41 |
| V2020 |
Frames, purchases |
607 |
597 |
$0.00 |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
567 |
557 |
$0.00 |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
170 |
169 |
$0.00 |