| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
819 |
792 |
$47K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
259 |
255 |
$14K |
| 92015 |
Determination of refractive state |
1,123 |
1,101 |
$3K |
| 92340 |
Fitting of spectacles, except for aphakia; monofocal |
174 |
166 |
$1K |
| V2020 |
Frames, purchases |
192 |
180 |
$330.90 |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
114 |
105 |
$0.00 |