| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
80 |
79 |
$55.60 |
| V2020 |
Frames, purchases |
84 |
83 |
$0.00 |
| S9986 |
Not medically necessary service (patient is aware that service not medically necessary) |
15 |
15 |
$0.00 |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
39 |
38 |
$0.00 |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
52 |
52 |
$0.00 |
| 92250 |
|
16 |
14 |
$0.00 |