| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92015 |
Determination of refractive state |
478 |
442 |
$10K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
174 |
161 |
$8K |
| V2020 |
Frames, purchases |
304 |
298 |
$2K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
75 |
75 |
$2K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
12 |
12 |
$710.23 |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
142 |
75 |
$291.70 |