| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
140 |
140 |
$7K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
100 |
100 |
$5K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
201 |
201 |
$3K |
| V2020 |
Frames, purchases |
253 |
249 |
$3K |
| 92015 |
Determination of refractive state |
237 |
237 |
$3K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
56 |
28 |
$1K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
37 |
19 |
$811.22 |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
500 |
246 |
$0.00 |
| 2026F |
|
37 |
37 |
$0.00 |