| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
88 |
85 |
$7K |
| V2020 |
Frames, purchases |
230 |
180 |
$6K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
35 |
32 |
$3K |
| 92015 |
Determination of refractive state |
262 |
248 |
$615.00 |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
207 |
163 |
$327.70 |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
212 |
166 |
$105.00 |