| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92250 |
|
60 |
60 |
$3K |
| V2020 |
Frames, purchases |
33 |
30 |
$532.00 |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
654 |
653 |
$482.97 |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
31 |
28 |
$285.00 |
| 92015 |
Determination of refractive state |
1,157 |
1,150 |
$0.00 |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
17 |
17 |
$0.00 |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
433 |
430 |
$0.00 |