| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
657 |
607 |
$32K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
723 |
722 |
$9K |
| 92015 |
Determination of refractive state |
466 |
451 |
$5K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
33 |
30 |
$2K |
| V2020 |
Frames, purchases |
566 |
563 |
$96.00 |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
216 |
216 |
$96.00 |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
111 |
111 |
$0.00 |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
24 |
24 |
$0.00 |