| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
92 |
83 |
$4K |
| V2020 |
Frames, purchases |
124 |
104 |
$3K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
19 |
19 |
$1K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
107 |
90 |
$31.18 |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
106 |
89 |
$0.00 |
| 92015 |
Determination of refractive state |
124 |
115 |
$0.00 |