| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
257 |
257 |
$27K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
148 |
148 |
$19K |
| 92015 |
Determination of refractive state |
579 |
579 |
$10K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
332 |
332 |
$10K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
353 |
351 |
$10K |
| V2020 |
Frames, purchases |
416 |
415 |
$4K |
| 92082 |
|
77 |
77 |
$2K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
46 |
46 |
$1K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
99 |
99 |
$0.00 |