| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92015 |
Determination of refractive state |
367 |
360 |
$11K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
193 |
182 |
$11K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
230 |
228 |
$7K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
16 |
16 |
$1K |
| V2020 |
Frames, purchases |
25 |
25 |
$80.00 |
| 3072F |
|
28 |
27 |
$0.00 |
| V2200 |
Sphere, bifocal, plano to plus or minus 4.00d, per lens |
12 |
12 |
$0.00 |