| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
345 |
341 |
$15K |
| 92015 |
Determination of refractive state |
743 |
716 |
$13K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
275 |
264 |
$12K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
281 |
275 |
$8K |
| V2020 |
Frames, purchases |
72 |
63 |
$789.04 |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
53 |
48 |
$667.59 |
| 2033F |
|
102 |
102 |
$0.00 |