| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
562 |
544 |
$26K |
| 92015 |
Determination of refractive state |
565 |
559 |
$15K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
220 |
217 |
$5K |
| V2020 |
Frames, purchases |
167 |
165 |
$1K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
12 |
12 |
$810.38 |
| 92134 |
|
12 |
12 |
$387.82 |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
14 |
14 |
$71.06 |