| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
999 |
999 |
$103K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
202 |
202 |
$26K |
| 92015 |
Determination of refractive state |
1,323 |
1,322 |
$23K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
606 |
606 |
$18K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
609 |
609 |
$17K |
| V2020 |
Frames, purchases |
609 |
608 |
$6K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
612 |
612 |
$0.00 |