| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
331 |
321 |
$14K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
173 |
169 |
$9K |
| V2020 |
Frames, purchases |
71 |
70 |
$3K |
| 92015 |
Determination of refractive state |
1,086 |
1,046 |
$1K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
48 |
41 |
$938.05 |
| 92250 |
|
12 |
12 |
$51.40 |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
39 |
39 |
$0.00 |