| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
345 |
342 |
$15K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
301 |
300 |
$14K |
| 92015 |
Determination of refractive state |
715 |
711 |
$11K |
| V2020 |
Frames, purchases |
272 |
269 |
$9K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
103 |
103 |
$3K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
124 |
124 |
$2K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
29 |
29 |
$488.68 |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
53 |
51 |
$146.74 |
| S0620 |
Routine ophthalmological examination including refraction; new patient |
59 |
59 |
$0.00 |