| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
317 |
308 |
$20K |
| 92015 |
Determination of refractive state |
431 |
416 |
$18K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
472 |
453 |
$13K |
| V2020 |
Frames, purchases |
171 |
162 |
$3K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
14 |
14 |
$1K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
83 |
43 |
$815.98 |