| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
105 |
97 |
$6K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
260 |
227 |
$4K |
| V2020 |
Frames, purchases |
149 |
133 |
$3K |
| S0621 |
Routine ophthalmological examination including refraction; established patient |
59 |
57 |
$3K |
| 92015 |
Determination of refractive state |
186 |
170 |
$2K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
18 |
16 |
$1K |
| 83861 |
|
71 |
36 |
$1K |
| 92370 |
|
67 |
64 |
$1K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
14 |
12 |
$152.44 |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
34 |
26 |
$146.48 |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
39 |
33 |
$0.00 |