| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
56 |
54 |
$2K |
| V2020 |
Frames, purchases |
123 |
115 |
$1K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
46 |
45 |
$768.10 |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
12 |
12 |
$630.00 |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
18 |
18 |
$0.00 |
| 92015 |
Determination of refractive state |
184 |
181 |
$0.00 |