| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
457 |
456 |
$39K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
1,197 |
1,171 |
$37K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
345 |
343 |
$31K |
| 92015 |
Determination of refractive state |
1,305 |
1,272 |
$14K |
| 92341 |
|
24 |
24 |
$854.55 |
| V2020 |
Frames, purchases |
489 |
481 |
$0.00 |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
503 |
495 |
$0.00 |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
140 |
140 |
$0.00 |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
12 |
12 |
$0.00 |