| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
932 |
820 |
$46K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
169 |
146 |
$8K |
| 92015 |
Determination of refractive state |
1,239 |
1,089 |
$6K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
286 |
276 |
$3K |
| V2103 |
Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens |
24 |
12 |
$272.16 |
| V2020 |
Frames, purchases |
13 |
13 |
$267.80 |