| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
295 |
282 |
$18K |
| V2020 |
Frames, purchases |
512 |
481 |
$15K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
28 |
27 |
$2K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
432 |
404 |
$2K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
423 |
394 |
$643.14 |
| 92015 |
Determination of refractive state |
675 |
649 |
$180.00 |