| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
218 |
209 |
$3K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
27 |
27 |
$1K |
| 92015 |
Determination of refractive state |
134 |
131 |
$889.00 |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
12 |
12 |
$440.00 |
| V2020 |
Frames, purchases |
169 |
166 |
$0.00 |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
30 |
29 |
$0.00 |