| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
219 |
209 |
$4K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
92 |
87 |
$4K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
59 |
58 |
$3K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
13 |
12 |
$264.00 |
| V2020 |
Frames, purchases |
13 |
13 |
$235.00 |
| 92015 |
Determination of refractive state |
189 |
186 |
$127.20 |