| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
719 |
719 |
$76K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
153 |
153 |
$20K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
552 |
549 |
$17K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
591 |
587 |
$16K |
| 92015 |
Determination of refractive state |
911 |
911 |
$16K |
| V2020 |
Frames, purchases |
578 |
574 |
$6K |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
27 |
25 |
$2K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
508 |
505 |
$0.00 |