| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
318 |
313 |
$11K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
306 |
306 |
$4K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
84 |
83 |
$1K |
| V2020 |
Frames, purchases |
177 |
176 |
$320.00 |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
52 |
37 |
$168.00 |
| 92015 |
Determination of refractive state |
32 |
32 |
$127.60 |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
169 |
90 |
$78.28 |
| 3072F |
|
43 |
42 |
$0.00 |
| S0620 |
Routine ophthalmological examination including refraction; new patient |
30 |
30 |
$0.00 |