| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92015 |
Determination of refractive state |
488 |
479 |
$13K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
203 |
201 |
$8K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
54 |
54 |
$1K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
20 |
18 |
$739.83 |
| V2020 |
Frames, purchases |
111 |
109 |
$214.05 |
| 2026F |
|
89 |
88 |
$0.00 |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
28 |
26 |
$0.00 |
| 2033F |
|
46 |
46 |
$0.00 |