| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
537 |
531 |
$22K |
| V2020 |
Frames, purchases |
494 |
494 |
$10K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
46 |
46 |
$2K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
20 |
20 |
$435.40 |
| 92015 |
Determination of refractive state |
112 |
112 |
$75.00 |
| 3072F |
|
187 |
185 |
$0.00 |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
254 |
254 |
$0.00 |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
83 |
83 |
$0.00 |