| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
85 |
85 |
$4K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
97 |
93 |
$2K |
| S0580 |
Polycarbonate lens (list this code in addition to the basic code for the lens) |
64 |
61 |
$1K |
| V2020 |
Frames, purchases |
80 |
77 |
$944.76 |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
12 |
12 |
$545.99 |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
45 |
45 |
$494.48 |