| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| V2020 |
Frames, purchases |
752 |
438 |
$11K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
185 |
157 |
$8K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
151 |
117 |
$6K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
609 |
329 |
$428.22 |
| 92015 |
Determination of refractive state |
589 |
485 |
$150.00 |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
605 |
329 |
$49.00 |