| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
890 |
890 |
$10K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
111 |
110 |
$2K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
112 |
112 |
$2K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
52 |
44 |
$1K |
| V2020 |
Frames, purchases |
557 |
556 |
$360.00 |
| 92015 |
Determination of refractive state |
52 |
52 |
$204.60 |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
325 |
167 |
$102.60 |
| V2760 |
Scratch resistant coating, per lens |
70 |
35 |
$0.00 |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
264 |
131 |
$0.00 |