| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| V2020 |
Frames, purchases |
320 |
309 |
$9K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
103 |
103 |
$8K |
| 92015 |
Determination of refractive state |
585 |
575 |
$6K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
150 |
142 |
$3K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
216 |
119 |
$1K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
14 |
14 |
$958.33 |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
14 |
12 |
$739.58 |