| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
53 |
52 |
$3K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
16 |
15 |
$1K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
18 |
17 |
$429.33 |
| V2020 |
Frames, purchases |
23 |
22 |
$168.00 |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
16 |
15 |
$40.00 |
| T1015 |
Clinic visit/encounter, all-inclusive |
98 |
93 |
$0.00 |
| 92015 |
Determination of refractive state |
92 |
90 |
$0.00 |