| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
323 |
323 |
$32K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
581 |
564 |
$16K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
131 |
131 |
$15K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
504 |
501 |
$15K |
| 92015 |
Determination of refractive state |
541 |
541 |
$9K |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
102 |
102 |
$7K |
| V2020 |
Frames, purchases |
510 |
507 |
$5K |
| 92370 |
|
38 |
37 |
$973.63 |