| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| V2020 |
Frames, purchases |
532 |
502 |
$42K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
315 |
296 |
$14K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
55 |
55 |
$2K |
| 92015 |
Determination of refractive state |
750 |
712 |
$2K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
511 |
481 |
$2K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
221 |
210 |
$584.64 |