| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
170 |
168 |
$9K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
129 |
128 |
$8K |
| V2020 |
Frames, purchases |
226 |
209 |
$5K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
153 |
141 |
$180.00 |
| 92015 |
Determination of refractive state |
266 |
260 |
$15.00 |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
28 |
27 |
$0.00 |