| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
1,163 |
1,118 |
$72K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
534 |
520 |
$40K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
1,728 |
1,687 |
$34K |
| 92015 |
Determination of refractive state |
2,061 |
2,016 |
$22K |
| 92341 |
|
202 |
202 |
$5K |
| V2020 |
Frames, purchases |
110 |
95 |
$2K |
| S0620 |
Routine ophthalmological examination including refraction; new patient |
12 |
12 |
$593.67 |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
18 |
17 |
$93.12 |
| 92202 |
|
15 |
14 |
$58.80 |
| 1036F |
|
144 |
142 |
$0.00 |