| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
261 |
99 |
$3K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
75 |
38 |
$2K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
73 |
72 |
$2K |
| 92342 |
|
13 |
13 |
$86.72 |
| V2020 |
Frames, purchases |
225 |
117 |
$79.82 |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
65 |
48 |
$0.00 |
| 92015 |
Determination of refractive state |
537 |
225 |
$0.00 |
| 2022F |
|
13 |
13 |
$0.00 |