| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
209 |
209 |
$22K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
157 |
157 |
$21K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
528 |
526 |
$16K |
| 92015 |
Determination of refractive state |
614 |
614 |
$11K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
249 |
248 |
$7K |
| V2020 |
Frames, purchases |
535 |
532 |
$5K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
96 |
95 |
$3K |