| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
521 |
521 |
$61K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
420 |
420 |
$39K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
523 |
522 |
$16K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
536 |
535 |
$15K |
| 92015 |
Determination of refractive state |
642 |
640 |
$11K |
| V2020 |
Frames, purchases |
509 |
506 |
$5K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
180 |
180 |
$0.00 |