| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
356 |
356 |
$36K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
99 |
99 |
$13K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
410 |
410 |
$12K |
| 92015 |
Determination of refractive state |
545 |
543 |
$9K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
171 |
171 |
$4K |
| V2020 |
Frames, purchases |
411 |
411 |
$4K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
80 |
80 |
$2K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
437 |
434 |
$0.00 |