| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
288 |
288 |
$38K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
215 |
215 |
$6K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
212 |
212 |
$6K |
| 92015 |
Determination of refractive state |
299 |
298 |
$5K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
40 |
40 |
$4K |
| 92250 |
|
91 |
91 |
$3K |
| V2020 |
Frames, purchases |
221 |
221 |
$2K |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
14 |
14 |
$1K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
123 |
123 |
$0.00 |