| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
713 |
681 |
$13K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
131 |
131 |
$2K |
| 92015 |
Determination of refractive state |
675 |
642 |
$1K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
57 |
57 |
$611.60 |
| V2020 |
Frames, purchases |
371 |
368 |
$220.00 |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
106 |
100 |
$84.00 |
| S0621 |
Routine ophthalmological examination including refraction; established patient |
15 |
15 |
$0.00 |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
49 |
26 |
$0.00 |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
26 |
13 |
$0.00 |