| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
112 |
104 |
$7K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
57 |
54 |
$3K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
171 |
155 |
$2K |
| V2020 |
Frames, purchases |
106 |
104 |
$319.53 |
| 92015 |
Determination of refractive state |
58 |
51 |
$62.18 |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
12 |
12 |
$0.00 |