| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
72 |
68 |
$3K |
| 92015 |
Determination of refractive state |
647 |
623 |
$3K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
48 |
48 |
$2K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
80 |
80 |
$2K |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
41 |
40 |
$2K |
| V2020 |
Frames, purchases |
13 |
13 |
$345.00 |