| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
42 |
42 |
$0.00 |
| V2020 |
Frames, purchases |
54 |
53 |
$0.00 |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
54 |
53 |
$0.00 |
| 92015 |
Determination of refractive state |
84 |
84 |
$0.00 |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
31 |
31 |
$0.00 |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
42 |
42 |
$0.00 |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
34 |
34 |
$0.00 |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
19 |
19 |
$0.00 |