| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
337 |
337 |
$37K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
549 |
549 |
$17K |
| 92015 |
Determination of refractive state |
903 |
902 |
$16K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
352 |
352 |
$10K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
51 |
51 |
$7K |
| V2020 |
Frames, purchases |
533 |
532 |
$5K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
26 |
26 |
$613.80 |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
609 |
608 |
$0.00 |