| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
259 |
227 |
$16K |
| V2020 |
Frames, purchases |
496 |
338 |
$8K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
74 |
66 |
$5K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
437 |
288 |
$5K |
| 92015 |
Determination of refractive state |
404 |
354 |
$4K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
378 |
252 |
$3K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
44 |
27 |
$292.32 |