| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
695 |
695 |
$54K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
321 |
321 |
$34K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
884 |
878 |
$26K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
911 |
903 |
$25K |
| 92015 |
Determination of refractive state |
1,005 |
1,005 |
$18K |
| V2020 |
Frames, purchases |
877 |
873 |
$9K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
904 |
897 |
$0.00 |