| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
2,069 |
2,055 |
$111K |
| 92015 |
Determination of refractive state |
2,725 |
2,709 |
$75K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
1,750 |
1,718 |
$56K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
300 |
300 |
$20K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
72 |
72 |
$0.00 |
| V2744 |
Tint, photochromatic, per lens |
12 |
12 |
$0.00 |
| V2200 |
Sphere, bifocal, plano to plus or minus 4.00d, per lens |
70 |
43 |
$0.00 |
| V2020 |
Frames, purchases |
437 |
433 |
$0.00 |
| V2750 |
Anti-reflective coating, per lens |
18 |
18 |
$0.00 |