| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| V2020 |
Frames, purchases |
330 |
308 |
$7K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
65 |
60 |
$5K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
56 |
50 |
$4K |
| 92015 |
Determination of refractive state |
457 |
420 |
$510.00 |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
256 |
243 |
$75.00 |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
30 |
24 |
$0.00 |