| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
202 |
193 |
$19K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
31 |
31 |
$3K |
| V2020 |
Frames, purchases |
306 |
291 |
$3K |
| 92015 |
Determination of refractive state |
346 |
330 |
$246.54 |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
273 |
260 |
$81.54 |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
309 |
294 |
$0.00 |