| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
561 |
561 |
$56K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
814 |
812 |
$24K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
825 |
822 |
$23K |
| 92015 |
Determination of refractive state |
886 |
886 |
$16K |
| V2020 |
Frames, purchases |
826 |
823 |
$8K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
15 |
15 |
$1K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
811 |
808 |
$0.00 |