| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
104 |
98 |
$5K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
167 |
163 |
$4K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
105 |
90 |
$3K |
| 92015 |
Determination of refractive state |
318 |
294 |
$1K |
| V2020 |
Frames, purchases |
207 |
186 |
$317.50 |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
15 |
15 |
$154.00 |
| 92342 |
|
30 |
30 |
$39.66 |
| V2756 |
Eye glass case |
29 |
29 |
$0.00 |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
97 |
88 |
$0.00 |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
14 |
14 |
$0.00 |
| 3072F |
|
13 |
13 |
$0.00 |
| 2022F |
|
13 |
13 |
$0.00 |