| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
44 |
43 |
$4K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
13 |
13 |
$1K |
| V2020 |
Frames, purchases |
154 |
146 |
$1K |
| 92015 |
Determination of refractive state |
181 |
174 |
$246.54 |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
121 |
113 |
$215.90 |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
169 |
162 |
$0.00 |