| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
440 |
386 |
$34K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
926 |
823 |
$17K |
| V2020 |
Frames, purchases |
920 |
796 |
$16K |
| 92015 |
Determination of refractive state |
1,066 |
925 |
$16K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
447 |
408 |
$11K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
159 |
151 |
$4K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
21 |
19 |
$2K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
43 |
38 |
$732.60 |
| 3072F |
|
96 |
90 |
$0.00 |