| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
298 |
294 |
$11K |
| 92015 |
Determination of refractive state |
714 |
685 |
$5K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
365 |
338 |
$5K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
12 |
12 |
$440.00 |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
304 |
304 |
$0.00 |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
27 |
27 |
$0.00 |
| V2020 |
Frames, purchases |
383 |
380 |
$0.00 |