| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
203 |
199 |
$13K |
| V2020 |
Frames, purchases |
361 |
310 |
$11K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
13 |
12 |
$780.00 |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
302 |
257 |
$418.86 |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
296 |
251 |
$345.00 |
| 92015 |
Determination of refractive state |
296 |
289 |
$287.17 |