| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
418 |
405 |
$17K |
| V2020 |
Frames, purchases |
252 |
225 |
$16K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
137 |
136 |
$6K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
99 |
92 |
$573.92 |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
54 |
51 |
$208.00 |
| 92015 |
Determination of refractive state |
570 |
545 |
$106.48 |