| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
458 |
447 |
$9K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
190 |
188 |
$7K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
37 |
37 |
$2K |
| 92015 |
Determination of refractive state |
78 |
75 |
$484.98 |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
12 |
12 |
$298.56 |
| V2020 |
Frames, purchases |
14 |
14 |
$220.00 |