| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
1,087 |
1,083 |
$1K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
173 |
87 |
$0.00 |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
446 |
222 |
$0.00 |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
24 |
24 |
$0.00 |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
52 |
26 |
$0.00 |
| V2020 |
Frames, purchases |
792 |
789 |
$0.00 |
| 92015 |
Determination of refractive state |
300 |
298 |
$0.00 |
| S0621 |
Routine ophthalmological examination including refraction; established patient |
31 |
31 |
$0.00 |
| V2760 |
Scratch resistant coating, per lens |
24 |
12 |
$0.00 |