| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
181 |
174 |
$8K |
| 92015 |
Determination of refractive state |
440 |
416 |
$7K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
352 |
338 |
$6K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
15 |
14 |
$200.00 |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
126 |
116 |
$10.00 |
| V2020 |
Frames, purchases |
113 |
103 |
$0.00 |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
13 |
12 |
$0.00 |