| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
255 |
254 |
$3K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
145 |
144 |
$2K |
| 92015 |
Determination of refractive state |
258 |
254 |
$708.40 |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
45 |
45 |
$420.00 |
| V2020 |
Frames, purchases |
241 |
237 |
$20.00 |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
24 |
12 |
$0.00 |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
86 |
40 |
$0.00 |