| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
111 |
110 |
$3K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
31 |
30 |
$2K |
| 92015 |
Determination of refractive state |
488 |
486 |
$898.95 |
| V2020 |
Frames, purchases |
41 |
41 |
$544.38 |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
57 |
56 |
$154.71 |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
12 |
12 |
$0.00 |