| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92015 |
Determination of refractive state |
634 |
627 |
$19K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
769 |
752 |
$18K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
173 |
170 |
$9K |
| V2020 |
Frames, purchases |
337 |
330 |
$3K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
201 |
124 |
$2K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
13 |
13 |
$864.65 |