| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 3072F |
|
166 |
166 |
$0.00 |
| 92342 |
|
181 |
180 |
$0.00 |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
126 |
63 |
$0.00 |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
57 |
57 |
$0.00 |
| V2756 |
Eye glass case |
181 |
180 |
$0.00 |
| V2020 |
Frames, purchases |
169 |
168 |
$0.00 |
| 92015 |
Determination of refractive state |
200 |
200 |
$0.00 |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
94 |
94 |
$0.00 |
| 2022F |
|
198 |
198 |
$0.00 |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
147 |
147 |
$0.00 |
| G0117 |
Glaucoma screening for high risk patients furnished by an optometrist or ophthalmologist |
200 |
200 |
$0.00 |