| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
468 |
455 |
$19K |
| V5110 |
Dispensing fee, bilateral |
96 |
96 |
$3K |
| 92015 |
Determination of refractive state |
382 |
378 |
$2K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
81 |
77 |
$2K |
| V2020 |
Frames, purchases |
54 |
51 |
$996.00 |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
15 |
14 |
$900.90 |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
19 |
18 |
$285.00 |