| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
317 |
310 |
$23K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
249 |
243 |
$13K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
482 |
451 |
$4K |
| V2020 |
Frames, purchases |
532 |
508 |
$438.50 |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
382 |
313 |
$22.00 |
| 92015 |
Determination of refractive state |
497 |
480 |
$0.00 |
| 92342 |
|
25 |
25 |
$0.00 |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
82 |
57 |
$0.00 |
| V2756 |
Eye glass case |
25 |
25 |
$0.00 |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
12 |
12 |
$0.00 |