| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
108 |
102 |
$6K |
| V2020 |
Frames, purchases |
153 |
73 |
$4K |
| 92060 |
|
73 |
71 |
$3K |
| 92250 |
|
45 |
43 |
$2K |
| 92015 |
Determination of refractive state |
272 |
235 |
$2K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
15 |
13 |
$1K |
| 92285 |
|
15 |
14 |
$84.21 |
| 92283 |
|
18 |
16 |
$0.00 |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
19 |
12 |
$0.00 |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
42 |
29 |
$0.00 |