| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
1,016 |
1,006 |
$37K |
| 92015 |
Determination of refractive state |
1,470 |
1,455 |
$11K |
| V2020 |
Frames, purchases |
445 |
440 |
$9K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
376 |
370 |
$8K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
73 |
73 |
$3K |
| 92250 |
|
13 |
13 |
$542.23 |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
36 |
36 |
$265.32 |