| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
920 |
909 |
$19K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
401 |
373 |
$7K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
90 |
90 |
$2K |
| 92015 |
Determination of refractive state |
442 |
441 |
$1K |
| V2020 |
Frames, purchases |
413 |
399 |
$240.00 |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
465 |
225 |
$105.00 |