| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
46 |
27 |
$3K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
16 |
12 |
$608.98 |
| 92015 |
Determination of refractive state |
73 |
57 |
$120.70 |
| V2750 |
Anti-reflective coating, per lens |
44 |
40 |
$0.00 |
| V2020 |
Frames, purchases |
56 |
51 |
$0.00 |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
59 |
54 |
$0.00 |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
16 |
12 |
$0.00 |