| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
1,204 |
1,200 |
$54K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
1,023 |
1,019 |
$20K |
| 92015 |
Determination of refractive state |
1,251 |
1,250 |
$5K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
33 |
33 |
$768.40 |
| V2020 |
Frames, purchases |
365 |
364 |
$260.00 |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
167 |
164 |
$0.00 |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
42 |
41 |
$0.00 |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
126 |
125 |
$0.00 |