| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
305 |
305 |
$31K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
204 |
204 |
$26K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
385 |
385 |
$11K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
349 |
349 |
$11K |
| 92015 |
Determination of refractive state |
339 |
338 |
$6K |
| V2020 |
Frames, purchases |
350 |
350 |
$3K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
16 |
16 |
$0.00 |