| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
68 |
68 |
$5K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
51 |
51 |
$2K |
| V2020 |
Frames, purchases |
50 |
47 |
$1K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
14 |
13 |
$1K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
16 |
13 |
$220.00 |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
15 |
15 |
$120.00 |
| V2760 |
Scratch resistant coating, per lens |
12 |
12 |
$24.00 |
| 92015 |
Determination of refractive state |
157 |
151 |
$0.00 |