| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
20 |
18 |
$1K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
30 |
30 |
$1K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
82 |
79 |
$163.49 |
| 92015 |
Determination of refractive state |
61 |
57 |
$56.50 |
| V2020 |
Frames, purchases |
65 |
62 |
$0.00 |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
50 |
32 |
$0.00 |