| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
376 |
366 |
$22K |
| 92015 |
Determination of refractive state |
401 |
391 |
$16K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
880 |
853 |
$14K |
| V2020 |
Frames, purchases |
998 |
966 |
$13K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
295 |
293 |
$9K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
949 |
919 |
$7K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
27 |
27 |
$2K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
23 |
21 |
$440.00 |
| 3072F |
|
12 |
12 |
$0.00 |