| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
13 |
13 |
$715.00 |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
12 |
12 |
$660.00 |
| V2020 |
Frames, purchases |
31 |
31 |
$465.00 |
| 2022F |
|
14 |
14 |
$0.00 |
| G0117 |
Glaucoma screening for high risk patients furnished by an optometrist or ophthalmologist |
43 |
43 |
$0.00 |
| 92015 |
Determination of refractive state |
44 |
44 |
$0.00 |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
16 |
16 |
$0.00 |
| 92342 |
|
31 |
31 |
$0.00 |
| V2756 |
Eye glass case |
31 |
31 |
$0.00 |