| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
491 |
491 |
$51K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
614 |
613 |
$19K |
| 92015 |
Determination of refractive state |
794 |
793 |
$11K |
| V2020 |
Frames, purchases |
612 |
611 |
$6K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
240 |
240 |
$5K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
26 |
26 |
$3K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
13 |
13 |
$348.75 |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
593 |
592 |
$0.00 |