| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92015 |
Determination of refractive state |
398 |
285 |
$14K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
350 |
247 |
$5K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
64 |
41 |
$4K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
19 |
17 |
$2K |
| V2020 |
Frames, purchases |
26 |
26 |
$164.06 |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
32 |
25 |
$55.56 |
| 2026F |
|
15 |
15 |
$0.00 |