| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
106 |
104 |
$6K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
55 |
51 |
$3K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
135 |
116 |
$1K |
| V2020 |
Frames, purchases |
119 |
100 |
$456.80 |
| 92015 |
Determination of refractive state |
179 |
172 |
$47.91 |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
33 |
32 |
$11.00 |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
17 |
12 |
$0.00 |