| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
261 |
257 |
$10K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
61 |
60 |
$2K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
42 |
42 |
$1K |
| V2020 |
Frames, purchases |
86 |
81 |
$1K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
47 |
47 |
$630.00 |
| 92015 |
Determination of refractive state |
27 |
27 |
$135.00 |