| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
262 |
249 |
$10K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
83 |
83 |
$2K |
| V2020 |
Frames, purchases |
101 |
101 |
$2K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
86 |
51 |
$1K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
101 |
101 |
$1K |
| 92015 |
Determination of refractive state |
349 |
294 |
$309.41 |
| T1015 |
Clinic visit/encounter, all-inclusive |
152 |
133 |
$0.00 |